Skip to main content
SpringerLink
Log in

Special Technique Considerations for Congenital Heart Disease Imaging

  • Chapter
  • First Online:
CT of the Heart

Part of the book series: Contemporary Medical Imaging ((CMI))

  • 2763 Accesses

Abstract

Given the varied imaging indications and often complex anatomy and physiology in patients with congenital heart disease, special techniques are often necessary to optimize the diagnostic information obtained. This chapter provides recommendations that can be utilized to optimize the diagnostic utility of cardiac CT in this patient population. Specifically, recommendations regarding the optimal imaging environment, sedation, venous access, injection protocols, scan triggering, sequence selection, interpretation, and reporting for patients with congenital heart disease are provided.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Han BK, Lesser AM, Vezmar M, Rosenthal K, Rutten-Ramos S, Lindberg J, Caye D, Lesser JR. Cardiovascular imaging trends in congenital heart disease: a single center experience. J Cardiovasc Comput Tomogr. 2013;7(6):361–6.

    Article  Google Scholar 

  2. Cohen MS, Eidem BW, Cetta F, Fogel MA, Frommelt PC, Ganame J, Han BK, Kimball TR, Johnson RK, Mertens L, Paridon SM, Powell AJ, Lopez L. Multimodality imaging guidelines of patients with transposition of the great arteries: a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2016;29(7):571–621.

    Article  Google Scholar 

  3. Han BK, Rigsby CK, Hlavacek A, Leipsic J, Nicol ED, Siegel MJ, Bardo D, Abbara S, Ghoshhajra B, Lesser JR, Raman S, Crean AM. Computed tomography imaging in patients with congenital heart disease part I: rationale and utility. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT): endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI). J Cardiovasc Comput Tomogr. 2015;9(6):475–92.

    Article  Google Scholar 

  4. Han BK, Rigsby CK, Leipsic J, Bardo D, Abbara S, Ghoshhajra B, Lesser JR, Raman SV, Crean AM, Nicol ED, Siegel MJ, Hlavacek A. Computed tomography imaging in patients with congenital heart disease, part 2: technical recommendations. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT): endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI). J Cardiovasc Comput Tomogr. 2015;9(6):493–513.

    Article  Google Scholar 

  5. Han BK, Overman DM, Grant K, Rosenthal K, Rutten-Ramos S, Cook D, Lesser JR. Non-sedated, free breathing cardiac CT for evaluation of complex congenital heart disease in neonates. J Cardiovasc Comput Tomogr. 2013;7(6):354–60.

    Article  Google Scholar 

  6. Bridoux A, Hutt A, Faivre JB, Flohr T, Duhamel A, Pagniez J, Remy J, Remy-Jardin M. Coronary artery visibility in free-breathing young children on non-gated chest CT: impact of temporal resolution. Pediatr Radiol. 2015;45(12):1761–70.

    Article  Google Scholar 

  7. Vastel-Amzallag C, Le Bret E, Paul JF, Lambert V, Rohnean A, El Fassy E, Sigal-Cinqualbre A. Diagnostic accuracy of dual-source multislice computed tomographic analysis for the preoperative detection of coronary artery anomalies in 100 patients with tetralogy of Fallot. J Thorac Cardiovasc Surg. 2011;142(1):120–6.

    Article  Google Scholar 

  8. Yang M, Mo XM, Jin JY, Zhang J, Liu B, Wu M, Teng GJ. Image quality and radiation exposure in pediatric cardiovascular CT angiography from different injection sites. AJR Am J Roentgenol. 2011;196(2):W117–22.

    Article  Google Scholar 

  9. Dewey M, Vavere AL, Arbab-Zadeh A, Miller JM, Sara L, Cox C, Gottlieb I, Yoshioka K, Paul N, Hoe J, de Roos A, Lardo AC, Lima JA, Clouse ME. Patient characteristics as predictors of image quality and diagnostic accuracy of MDCT compared with conventional coronary angiography for detecting coronary artery stenoses: CORE-64 Multicenter International Trial. AJR Am J Roentgenol. 2010;194(1):93–102.

    Article  Google Scholar 

  10. Mahabadi AA, Achenbach S, Burgstahler C, Dill T, Fischbach R, Knez A, Moshage W, Richartz BM, Ropers D, Schroder S, Silber S, Mohlenkamp S. Safety, efficacy, and indications of beta-adrenergic receptor blockade to reduce heart rate prior to coronary CT angiography. Radiology. 2010;257(3):614–23.

    Article  Google Scholar 

  11. Gordic S, Husarik DB, Desbiolles L, Leschka S, Frauenfelder T, Alkadhi H. High-pitch coronary CT angiography with third generation dual-source CT: limits of heart rate. Int J Cardiovasc Imaging. 2014;30(6):1173–9.

    Article  Google Scholar 

  12. Han BK, Lindberg J, Overman D, Schwartz RS, Grant K, Lesser JR. Safety and accuracy of dual-source coronary computed tomography angiography in the pediatric population. J Cardiovasc Comput Tomogr. 2012;6(4):252–9.

    Article  Google Scholar 

  13. Cui Y, Huang M, Zheng J, Li J, Liu H, Liang C. Assessments of coronary artery visibility and radiation dose in infants with congenital heart disease on cardiac 128-slice CT and on cardiac 64-slice CT. Pediatr Cardiol. 2016;37(1):135–43.

    Article  CAS  Google Scholar 

  14. Saake M, Lell MM, Rompel O, Gloeckler M, May M, Eller A, Achenbach S, Uder M, Wuest W. Contrast medium application in pediatric high-pitch cardiovascular CT angiography: manual or power injection? J Cardiovasc Comput Tomogr. 2014;8(4):315–22.

    Article  Google Scholar 

  15. Amaral JG, Traubici J, BenDavid G, Reintamm G, Daneman A. Safety of power injector use in children as measured by incidence of extravasation. AJR Am J Roentgenol. 2006;187(2):580–3.

    Article  Google Scholar 

  16. Halliburton S, Arbab-Zadeh A, Dey D, Einstein AJ, Gentry R, George RT, Gerber T, Mahesh M, Weigold WG. State-of-the-art in CT hardware and scan modes for cardiovascular CT. J Cardiovasc Comput Tomogr. 2012;6(3):154–63.

    Article  Google Scholar 

  17. Beeres M, Schell B, Mastragelopoulos A, Herrmann E, Kerl JM, Gruber-Rouh T, Lee C, Siebenhandl P, Bodelle B, Zangos S, Vogl TJ, Jacobi V, Bauer RW. High-pitch dual-source CT angiography of the whole aorta without ECG synchronisation: initial experience. Eur Radiol. 2012;22(1):129–37.

    Article  Google Scholar 

  18. Shuman WP, Leipsic JA, Busey JM, Green DE, Pipavath SN, Hague CJ, Koprowicz KM. Prospectively ECG gated CT pulmonary angiography versus helical ungated CT pulmonary angiography: impact on cardiac related motion artifacts and patient radiation dose. Eur J Radiol. 2012;81(9):2444–9.

    Article  Google Scholar 

  19. Jin KN, Park EA, Shin CI, Lee W, Chung JW, Park JH. Retrospective versus prospective ECG-gated dual-source CT in pediatric patients with congenital heart diseases: comparison of image quality and radiation dose. Int J Cardiovasc Imaging. 2010;26(Suppl 1):63–73.

    Article  Google Scholar 

  20. Duan Y, Wang X, Cheng Z, Wu D, Wu L. Application of prospective ECG-triggered dual-source CT coronary angiography for infants and children with coronary artery aneurysms due to Kawasaki disease. Br J Radiol. 2012;85(1020):e1190–7.

    Article  CAS  Google Scholar 

  21. Paul JF, Rohnean A, Elfassy E, Sigal-Cinqualbre A. Radiation dose for thoracic and coronary step-and-shoot CT using a 128-slice dual-source machine in infants and small children with congenital heart disease. Pediatr Radiol. 2011;41(2):244–9.

    Article  Google Scholar 

  22. Tada A, Sato S, Kanie Y, Tanaka T, Inai R, Akagi N, Morimitsu Y, Kanazawa S. Image quality of coronary computed tomography angiography with 320-row area detector computed tomography in children with congenital heart disease. Pediatr Cardiol. 2016;37(3):497–503.

    Article  Google Scholar 

  23. Alkadhi H, Stolzmann P, Desbiolles L, Baumueller S, Goetti R, Plass A, Scheffel H, Feuchtner G, Falk V, Marincek B, Leschka S. Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart. 2010;96(12):933–8.

    Article  Google Scholar 

  24. Ghadimi Mahani M, Agarwal PP, Rigsby CK, Lu JC, Fazeli Dehkordy S, Wright RA, Dorfman AL, Krishnamurthy R. CT for assessment of thrombosis and pulmonary embolism in multiple stages of single-ventricle palliation: challenges and suggested protocols. Radiographics. 2016;36(5):1273–84.

    Article  Google Scholar 

  25. Prabhu SP, Mahmood S, Sena L, Lee EY. MDCT evaluation of pulmonary embolism in children and young adults following a lateral tunnel Fontan procedure: optimizing contrast-enhancement techniques. Pediatr Radiol. 2009;39(9):938–44.

    Article  Google Scholar 

  26. Sandler KL, Markham LW, Mah ML, Byrum EP, Williams JR. Optimizing CT angiography in patients with Fontan physiology: single-center experience of dual-site power injection. Clin Radiol. 2014;69(12):e562–7.

    Article  CAS  Google Scholar 

  27. Park EA, Lee W, Chung SY, Yin YH, Chung JW, Park JH. Optimal scan timing and intravenous route for contrast-enhanced computed tomography in patients after Fontan operation. J Comput Assist Tomogr. 2010;34(1):75–81.

    Article  Google Scholar 

  28. Grewal J, Al Hussein M, Feldstein J, Kiess M, Ellis J, Human D, Leipsic J. Evaluation of silent thrombus after the Fontan operation. Congenit Heart Dis. 2013;8(1):40–7.

    Article  Google Scholar 

  29. Di Sessa TG, Di Sessa P, Gregory B, Vranicar M. The use of 3D contrast-enhanced CT reconstructions to project images of vascular rings and coarctation of the aorta. Echocardiography. 2009;26(1):76–81.

    Article  Google Scholar 

  30. Lee EY, Siegel MJ, Hildebolt CF, Gutierrez FR, Bhalla S, Fallah JH. MDCT evaluation of thoracic aortic anomalies in pediatric patients and young adults: comparison of axial, multiplanar, and 3D images. AJR Am J Roentgenol. 2004;182(3):777–84.

    Article  Google Scholar 

  31. Lee EY, Tracy DA, Mahmood SA, Weldon CB, Zurakowski D, Boiselle PM. Preoperative MDCT evaluation of congenital lung anomalies in children: comparison of axial, multiplanar, and 3D images. AJR Am J Roentgenol. 2011;196(5):1040–6.

    Article  Google Scholar 

  32. Brandt PW, Calder AL. Cardiac connections: the segmental approach to radiologic diagnosis in congenital heart disease. Curr Probl Diagn Radiol. 1977;7(3):1–35.

    Article  CAS  Google Scholar 

  33. Lapierre C, Dery J, Guerin R, Viremouneix L, Dubois J, Garel L. Segmental approach to imaging of congenital heart disease. Radiographics. 2010;30(2):397–411.

    Article  Google Scholar 

  34. Shinebourne EA, Macartney FJ, Anderson RH. Sequential chamber localization--logical approach to diagnosis in congenital heart disease. Br Heart J. 1976;38(4):327–40.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA

    Anthony M. Hlavacek

Authors
  1. Anthony M. Hlavacek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anthony M. Hlavacek .

Editor information

Editors and Affiliations

  1. Department of Radiology, Center for Advanced Imaging Research (CAIR), Medical University of South Carolina, Charleston, SC, USA

    U. Joseph Schoepf

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Humana Press

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hlavacek, A.M. (2019). Special Technique Considerations for Congenital Heart Disease Imaging. In: Schoepf, U. (eds) CT of the Heart. Contemporary Medical Imaging. Humana, Totowa, NJ. https://doi.org/10.1007/978-1-60327-237-7_44

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-237-7_44

  • Published:

  • Publisher Name: Humana, Totowa, NJ

  • Print ISBN: 978-1-60327-236-0

  • Online ISBN: 978-1-60327-237-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation