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Feasibility of using a non-sedation protocol for evaluation of neonatal congenital heart disease by using a 16-cm wide-detector computed tomography with a low radiation dose: preliminary experience from a single pediatric medical center

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Abstract

The aim of this study is to explore the feasibility of using a non-sedation protocol for the evaluation of neonatal congenital heart disease by using 16-cm wide-detector CT with a low radiation dose. Thirty-four neonates (group 1) were enrolled to undergo cardiac CT without sedation between August 2018 and March 2019. The control group (group 2) comprising 20 inpatient neonates was sedated. Cardiac CT was performed using 16-cm area detector 320-row CT with free breathing and prospective ECG-triggering scan mode. The examination completion time, radiation dose, and image quality were compared between the groups. The results of cardiac CT for patients in group 1 who underwent surgery were compared with surgical findings. Intergroup differences in body weight, age, examination completion time, radiation dose, and image quality evaluation were not significant. There was no significant difference in oxygen saturation before and after the examination in group 1. In all, 98 separate cardiovascular abnormalities in 27 group 1 patients were confirmed using surgical reports. The overall sensitivity, specificity, positive predictive value, and negative predictive value of cardiac CT were 94.90%, 100.0%, 100.0%, and 98.53%. The non-sedation protocol can be applied in neonates with congenital heart disease by using 16-cm wide-detector CT with a low radiation dose. Based on the image quality obtained, non-sedative examination did not extend the examination completion time and helped avoid the possible side effects of sedative drugs.

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Abbreviations

CNS:

Central nervous system

DLP:

Dose length product

CTDI:

CT dose index

ED:

Effective dose

SNR:

Signal-to-noise ratio

ROI:

Region of interest

MIP:

Maximum intensity projection

MinIP:

Minimum intensity projection

MPR:

Multiplanar reformation

VR:

Volume render

ICC:

Intraclass correlation coefficient

ROC:

Receiver operating characteristic

AUC:

Area under curve

CHD:

Congenital heart disease

AAO:

Ascending aorta

PA:

Pulmonary artery

ASD:

Atrial septal defect

PFO:

Patent foramen ovale

VSD:

Ventricular septal defect

PDA:

Patent ductus arteriosus

TAPVC:

Total anomalous pulmonary venous connection

D-TGA:

Complete transposition of the great arteries

HLHS:

Hypoplastic left heart syndrome

IAA:

Interrupted aortic arch

DORV:

Double-outlet right ventricle

PA/VSD:

Pulmonary atresia with ventricular septal defect

PS:

Pulmonary valve stenosis

PTA:

Persistent truncus arteriosus

TA:

Tricuspid atresia

CoA:

Coarctation of the aorta

SV:

Single ventricle

TP:

True positive

TN:

True negative

FP:

False positive

FN:

False negative

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Acknowledgements

We want to thank Mr. Ting-Fan Wu for the statistical advice.

Funding

The present study was funded by National Key R & D Program of China (Grant No. 2018YFB1107100), Shanghai Municipal Commission of Health and Family Planning (Grant No. 201740095), and Key Projects of Shanghai Science and Technology Commission (Grant No. 17411953300).

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Author notes

  1. Chen Guo and Yu-Jie Liu share equal contribution.

  2. Yu-Min Zhong and Qian Wang have equal contribution.

Authors and Affiliations

  1. Diagnostic Imaging Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People’s Republic of China

    Chen Guo, Ai-Min Sun, Rong-Zhen Ouyang, Li-Wei Hu, Wei-Hui Xie, Hai-Sheng Qiu, Yu-Min Zhong & Qian Wang

  2. Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People’s Republic of China

    Yu-Jie Liu, Hai-Bo Zhang & Zhuo-Ming Xu

  3. Canon Medical Systems (China), Zhongshan Wanbo International Center, 10th floor, 666 Huaihai West Road, Shanghai, 200052, People’s Republic of China

    Jia-Qi Sun

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  1. Chen Guo
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  2. Yu-Jie Liu
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Correspondence to Yu-Min Zhong or Qian Wang.

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Guo, C., Liu, YJ., Sun, AM. et al. Feasibility of using a non-sedation protocol for evaluation of neonatal congenital heart disease by using a 16-cm wide-detector computed tomography with a low radiation dose: preliminary experience from a single pediatric medical center. Int J Cardiovasc Imaging 37, 2303–2310 (2021). https://doi.org/10.1007/s10554-021-02197-0

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  • DOI: https://doi.org/10.1007/s10554-021-02197-0

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