Pediatric Cardiology

, Volume 38, Issue 7, pp 1393–1399 | Cite as

Image Quality of Coronary Arteries on Non-electrocardiography-gated High-Pitch Dual-Source Computed Tomography in Children with Congenital Heart Disease

  • Yuichiro Kanie
  • Shuhei Sato
  • Akihiro Tada
  • Susumu Kanazawa
Original Article


This study aimed to evaluate image quality of coronary artery imaging on non-electrocardiography (ECG)-gated high-pitch dual-source computed tomography (DSCT) in children with congenital heart disease (CHD) and to assess factors affecting image quality. We retrospectively reviewed the records of 142 children with CHD who underwent non-ECG-gated high-pitch DSCT. The subjective image quality of the proximal coronary segments was graded using a five-point scale. A score <3 represented a non-diagnostic image. Age, body weight, and heart rate were compared between the two groups: patients with good diagnostic image quality in all four segments and patients with at least one segment with non-diagnostic image quality. Predictors of image quality were assessed by multivariate logistic regression, including age, body weight, and heart rate. Four-hundred-fifty-seven of the 568 segments (80.5%) had diagnostic image quality. Patients with non-diagnostic segments were significantly younger (21.6 ± 25.5 months), had lower body weight (7.82 ± 5.00 kg), and a faster heart rate (123 ± 23.7 beats/min) (each p < 0.05) than patients with diagnostic image quality in all four segments (30.6 ± 20.7 months, 10.3 ± 4.00 kg, and 113 ± 21.6 beats/min, respectively; each p < 0.05). The multivariate logistic regression revealed that body weight (odds ratio 1.228; p = 0.029) was a significant predictor of image quality. Non-ECG-gated high-pitch DSCT provided adequate image quality of the proximal coronary segments in children with CHD. Lower body weight was a factor that led to poorer image quality of the coronary arteries.


Congenital heart disease High pitch Dual-source CT Non-ECG-gated Coronary CT angiography 



The authors would like to express our appreciation to Mr. Noriaki Akagi (Division of Radiology, Okayama University Hospital) for his technical advice.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.


  1. 1.
    Goo HW, Seo DM, Yun TJ, Park JJ, Park IS, Ko JK, Kim YH (2009) Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multislice CT findings. Pediatr Radiol 39:265–273. doi: 10.1007/s00247-008-1111-7 CrossRefPubMedGoogle Scholar
  2. 2.
    Angeli E, Formigari R, Pace Napoleone C, Oppido G, Ragni L, Picchio FM, Gargiulo G (2010) Long-term coronary artery outcome after arterial switch operation for transposition of the great arteries. Eur J Cardiothorac Surg 38:714–720. doi: 10.1016/j.ejcts.2010.03.055 CrossRefPubMedGoogle Scholar
  3. 3.
    Goo HW, Park IS, Ko JK, Kim YH, Seo DM, Yun TJ, Park JJ (2005) Visibility of the origin and proximal course of coronary arteries on non-ECG-gated heart CT in patients with congenital heart disease. Pediatr Radiol 35:792–798. doi: 10.1007/s00247-005-1482-y CrossRefPubMedGoogle Scholar
  4. 4.
    Tsai IC, Lee T, Chen MC, Fu YC, Jan SL, Wang CC, Chang Y (2007) Visualization of neonatal coronary arteries on multidetector row CT: ECG-gated versus non-ECG-gated technique. Pediatr Radiol 37:818–825. doi: 10.1007/s00247-007-0512-3 CrossRefPubMedGoogle Scholar
  5. 5.
    Nie P, Wang X, Cheng Z, Ji X, Duan Y, Chen J (2012) Accuracy, image quality and radiation dose comparison of high-pitch spiral and sequential acquisition on 128-slice dual-source CT angiography in children with congenital heart disease. Eur Radiol 22:2057–2066. doi: 10.1007/s00330-012-2479-1 CrossRefPubMedGoogle Scholar
  6. 6.
    Jadhav SP, Golriz F, Atweh LA, Zhang W, Krishnamurthy R (2015) CT angiography of neonates and infants: comparison of radiation dose and image quality of target mode prospectively ECG-gated 320-MDCT and ungated helical 64-MDCT. AJR Am J Roentgenol 204:W184–W191. doi: 10.2214/AJR.14.12846 CrossRefPubMedGoogle Scholar
  7. 7.
    de Malherbe M, Duhamel A, Tacelli N, Hachulla AL, Pontana F, Faivre JB, Remy J, Remy-Jardin M (2012) Ultrafast imaging of the entire chest without ECG synchronisation or beta-blockade: to what extent can we analyse the coronary arteries? Insights Imaging 3:73–79. doi: 10.1007/s13244-011-0133-0 CrossRefPubMedGoogle Scholar
  8. 8.
    Han BK, Lindberg J, Grant K, Schwartz RS, Lesser JR (2011) Accuracy and safety of high pitch computed tomography imaging in young children with complex congenital heart disease. Am J Cardiol 107:1541–1546. doi: 10.1016/j.amjcard.2011.01.065 CrossRefPubMedGoogle Scholar
  9. 9.
    Thomas KE, Wang B (2008) Age-specific effective doses for pediatric MSCT examinations at a large children’s hospital using DLP conversion coefficients: a simple estimation method. Pediatr Radiol 38:645–656. doi: 10.1007/s00247-008-0794-0 CrossRefPubMedGoogle Scholar
  10. 10.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMedGoogle Scholar
  11. 11.
    Ben Saad M, Rohnean A, Sigal-Cinqualbre A, Adler G, Paul JF (2009) Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease. Pediatr Radiol 39:668–676. doi: 10.1007/s00247-009-1209-6 CrossRefPubMedGoogle Scholar
  12. 12.
    Bridoux A, Hutt A, Faivre JB, Flohr T, Duhamel A, Pagniez J, Remy J, Remy-Jardin M (2015) Coronary artery visibility in free-breathing young children on non-gated chest CT: impact of temporal resolution. Pediatr Radiol 45:1761–1770. doi: 10.1007/s00247-015-3401-1 CrossRefPubMedGoogle Scholar
  13. 13.
    Goo HW, Yang DH (2010) Coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT: dual-source ECG-triggered sequential scan vs. single-source non-ECG-synchronized spiral scan. Pediatr Radiol 40:1670–1680. doi: 10.1007/s00247-010-1693-8 CrossRefPubMedGoogle Scholar
  14. 14.
    Pache G, Grohmann J, Bulla S, Arnold R, Stiller B, Schlensak C, Langer M, Blanke P (2011) Prospective electrocardiography-triggered CT angiography of the great thoracic vessels in infants and toddlers with congenital heart disease: feasibility and image quality. Eur J Radiol 80:e440–e445. doi: 10.1016/j.ejrad.2011.01.032 CrossRefPubMedGoogle Scholar
  15. 15.
    Yu FF, Lu B, Gao Y, Hou ZH, Schoepf UJ, Spearman JV, Cao HL, Sun ML, Jiang SL (2013) Congenital anomalies of coronary arteries in complex congenital heart disease: diagnosis and analysis with dual-source CT. J Cardiovasc Comput Tomogr 7:383–390. doi: 10.1016/j.jcct.2013.11.004 CrossRefPubMedGoogle Scholar
  16. 16.
    Tada A, Sato S, Kanie Y, Tanaka T, Inai R, Akagi N, Morimitsu Y, Kanazawa S (2016) Image quality of coronary computed tomography angiography with 320-row area detector computed tomography in children with congenital heart disease. Pediatr Cardiol 37:497–503. doi: 10.1007/s00246-015-1305-3 CrossRefPubMedGoogle Scholar
  17. 17.
    Stolzmann P, Goetti RP, Maurovich-Horvat P, Hoffmann U, Flohr TG, Leschka S, Alkadhi H (2011) Predictors of image quality in high-pitch coronary CT angiography. AJR Am J Roentgenol 197:851–858. doi: 10.2214/AJR.10.6072 CrossRefPubMedGoogle Scholar
  18. 18.
    Nakagawa M, Ozawa Y, Sakurai K, Shimohira M, Ohashi K, Asano M, Yamaguchi S, Shibamoto Y (2015) Image quality at low tube voltage (70 kV) and sinogram-affirmed iterative reconstruction for computed tomography in infants with congenital heart disease. Pediatr Radiol 45:1472–1479. doi: 10.1007/s00247-015-3372-2 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of RadiologyOkayama University Medical SchoolOkayamaJapan

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