Use of 320-Detector Computed Tomographic Angiography for Infants and Young Children with Congenital Heart Disease
Use of 320-Detector Computed Tomographic Angiography for Infants and Young Children with Congenital Heart Disease
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DOI：
10.1007/s00246-010-9873-8
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发表时间：
2011-04-01
影响因子：
1.6
通讯作者：
Chandran, Arun
中科院分区：
文献类型：
--
作者：
Al-Mousily, Faris;Shifrin, Roger Y.;Chandran, Arun
患有复杂先天性心脏病（CHD）的儿童患者面临着终身的介入治疗和姑息治疗。超声心动图仍然是先天性心脏病无创成像的主要手段。这往往是补充诊断心导管插入术的额外解剖和生理特征。然而，最近计算机断层扫描（CT）和磁共振成像（MRI）的技术改进，使人们更加关注这些技术的使用，因为它们具有更好的安全性。本研究旨在回顾作者使用320层多层螺旋CT扫描仪评估儿童CHD的经验。这项回顾性病例研究调查了22名婴儿和幼儿与临时诊断冠心病。使用320层Aquilon ONE CT扫描仪进行解剖学评价。在这22例患者中，14例未进行心脏门控检查。随后将其修改为前瞻性门控靶向方案，以减少辐射剂量。由一名经验丰富的放射科医生和一名儿科心脏病专家解读图像。连续变量表示为平均值和标准差或范围，并比较两种成像方案。还将暴露率与使用64层CT血管造影术的其他儿科研究进行了比较。对于第一组患者，未进行CT检查，平均有效全身辐射剂量为1.8 +/- A 0.71毫西弗（mSv）（范围，0.96-3.2 mSv）。对于第二组，平均值为0.8 +/- A 0.39 mSv（范围：0.4-1.5 mSv）。虽然辐射剂量大大减少，但临床医生必须警惕辐射暴露的累积风险。
Pediatric patients with complex congenital heart disease (CHD) face a lifetime of treatment with interventional therapeutic and palliative procedures. Echocardiography remains the mainstay for noninvasive imaging of congenital heart lesions. This often is supplemented with diagnostic cardiac catheterization for additional anatomic and physiologic characterization. However, recent technological improvements in computed tomography (CT) and magnetic resonance imaging (MRI) have led to an increased focus on the use of these techniques given their better safety profile. This study aimed to review the authors' experience with a 320-slice multidetector CT scanner in the evaluation of CHD in children. This retrospective case study investigated 22 infants and young children with a provisional diagnosis of CHD. Their anatomic evaluation was performed using a 320-slice Aquilon ONE CT scanner. Of these 22 patients, 14 were examined without cardiac gating. This was subsequently modified to a prospective gated, targeted protocol to decrease the radiation dose. The images were interpreted by an experienced radiologist and a pediatric cardiologist. Continuous variables were expressed as mean and standard deviation or range, and the two imaging protocols were compared. A comparison of exposure rates with those from other pediatric studies that had used the 64-slice CT angiography also was performed. For the first group of patients, with nongated CT examinations, the mean effective whole-body radiation dose was 1.8 +/- A 0.71 millisieverts (mSv) (range, 0.96-3.2 mSv). For the second group, the mean was 0.8 +/- A 0.39 mSv (range, 0.4-1.5 mSv). Although the radiation dose was reduced dramatically, clinicians must be vigilant about the cumulative risk of radiation exposure.