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J Cardiovasc Comput Tomogr. 2012 Jul-Aug;6(4):252-9. doi: 10.1016/j.jcct.2012.01.004. Epub 2012 Jun 5.

Safety and accuracy of dual-source coronary computed tomography angiography in the pediatric population.

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  • 1Children's Heart Clinic Minneapolis, MN, USA.

Abstract

BACKGROUND:

High heart rates and radiation sensitivity have limited the use of coronary computed tomography angiography (CTA) in pediatric patients.

OBJECTIVE:

A contemporary evaluation of image quality and reduction in radiation exposure with dual-source CT technology has not been reported in a large cohort of pediatric patients undergoing coronary angiography.

METHODS:

Consecutive coronary CTA scans (n = 71) in 70 pediatric patients were retrospectively reviewed. Metoprolol was administered for heart rate control. Scans were divided by acquisition mode into 3 groups: retrospective electrocardiogram (ECG)-triggered spiral, prospective ECG-triggered, and prospective ECG-triggered high-pitch spiral scans. Heart rate, radiation dose, image quality, and diagnostic confidence were compared between groups.

RESULTS:

Median decrease in heart rate with metoprolol was 24% ± 14%. Median effective age-adjusted radiation dose for the entire group was 0.97 ± 1.20 mSv. Retrospective ECG-triggered scans had a median dose of 1.71 ± 1.4 mSv, prospectively ECG-triggered scans had a median dose of 0.9 ± 1.1 mSv, and prospectively ECG-triggered high-pitch spiral scans had a median effective dose of 0.27 ± 0.4 mSv. The difference between groups was statistically significant (P < 0.05). The contrast-to-noise ratio and the image quality score were similar between groups.

CONCLUSION:

Dual-source coronary CTA with a β-blocker protocol uniformly achieves diagnostic coronary scans at a low radiation dose in pediatric patients. Image quality and diagnostic confidence are excellent for all scan modes in a wide spectrum of patients.

Copyright © 2012 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

PMID:
22732198
[PubMed - indexed for MEDLINE]
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