The Feasibility Of Prospective Ecg-Gated Dual-Sorce CT In Infants With Congenital Heart Disease

ObjectiveTo compare radiation dose and image quality between prospective and retrospective ECG gating CT cardiac angiography(CTA) with dual-source computed tomography (DSCT) CT scanner .MethodsNinety patient with suspected congital heart disease were selected ,and randomly devided into two groups . Forty-five patients in research group (average age:5.60m,weight: 6.51kg,height: 59.48cm,heart rate : 121.89 bpm) underwent CTA using prospective ECG-gating (80kv,mA tailored to weight),while the rest 45 patients (average age:6.28m,weight:6.17kg,height:58.95cm,heart126.10bpm)in control group underwent CTA using retrospective ECG-gating (80kv,mA tailored to weight). The patient demography in terms of sex , age ,height ,weight and heart rate were similar for the two groups. Two experienced radiologists quantitatively evaluated the image quality blindly. The imaging noises were measured at the same time for the two sets .And recored the CTDI,DLP values for each group to reflect overall raditon dose to patients.We performed statistical analyses on the quality scores, the nosie measurements and the effective dose measurements from two sets using t-test with SPSS 13.0 software.ResultsThere is no statistical difference in image quality between A and B group(H=0.098, P>0.05 ) .The nosie measurements for A and B groups were 13.25±1.27 ,13.51±1.41,respectively,with t-test of P>0.05 indicating no statistical difference. In addition ,the CTDI,DLP,Effective dose values were 2.70±0.75 mGY,29.55±10.17 mGy/cm,0.41±0.14 mSv ;3.81±1.03 mGY,51.57±14.81 mGy/cm,0.72±0.20 mSv,respectively ,with t-test of P<0.05 with indicating statistically significant lower dosage with prospective ECG gating CTA.ConclusionProspective ECG gating CTA can effectively reduce the infant's radiation dose without compromising image quality. ObjectiveTo explore the clinical application of of dual-source CT(DSCT)ECG gating CT cardiac angiography (CTA)in diagnosing congenital heart disease (CHD).Methods 46 infants (male 30 ,female 16, average age : 6.78 m, average weight:6.88kg)with diagnosed CHD underwent CTA, among them ,21cases underwent prospective ECG-triggering DSCT angiography ,25 cases underwent reospective ECG-triggering DSCT angiography . multiple plane reorganization (MPR),maximum intensity projection (MIP),and volume renderwere (VR)used to reconstruct the original image on the workstation by two experienced doctors to do image diagnosis.All cases were confirmed by surgery.ResultsThe CTDI,DLP,Effective dose values were 2.97±0.85 mGY,32.95±12.28,0.46±0.17 mSv ;3.95±1.09 mGY,54.12±16.07mGy/cm,0.75±0.22 mSv;,respectively ,with t-test of P<0.05 with indicating statistically significant lower dosage with prospective ECG gating CTA. surgical confirmed deformity 225cases (in group C 93cases, in group D 132 cases, DSCT general diagnosis accurancy 84%).1)intracardiac deformity : in group C ,operation confirmed 43cases,DSCT detected accuracy is 72.1%, in group D operation confirmed 53 cases, retrospective heart ECG-trigger DSCT detected accuracy is 69.8%.2) heart-vessel conjunction deformities :Group C heart surgery confirmed the great vessels connection deformity in 16 cases ,DSCT prospective ECG-triggering detected is 93.8%, in group D operation confirmed 18cases, retrospective heart ECG-trigger DSCT detected accuracy is 83.3%.3)great vessels deformity : in group C ,operation confirmed 46 cases, DSCT detected accuracy is 93.5%, in group D operation confirmed 61 cases, retrospective heart ECG-trigger DSCT detected accuracy is 95.1%. By surgical results for the standard, two scanning mode in the intracardiac deformity, heart-vessel conjunction deformities, great vessels deformity was not statistically significant.4)Recored the CTDI,DLP values for each group to reflect overall raditon dose to patients.ConclusionProspective ECG-triggering DSCT angiography with a very low effective radiation dose allows the accurate diagnosis of anomalies in infants with CHD .