Image quality and radiation dose of ECG-triggered High-Pitch Dual-Source cardiac computed tomography angiography in children for the evaluation of central vascular stents

Int J Cardiovasc Imaging. 2019 Feb;35(2):367-374. doi: 10.1007/s10554-019-01539-3. Epub 2019 Jan 25.

Abstract

Assess image quality and radiation dose of ECG-triggered High-Pitch Dual-Source CTA for the evaluation central vascular stents in children. We included all children ≤ 21 years old with one or more central vascular stents and available prospective ECG-triggered High-Pitch Dual-Source CTA performed at our institution between January 2015 and August 2017. Demographic and scanner information was retrieved. Two board-certified pediatric radiologists blinded to the clinical data, independently reviewed and scored each case using a four-point quality score. Scores 1, 2 and 3 were considered of diagnostic image quality. Inter-observer agreement and non-parametric test were used. 18 patients (10 girls, 8 boys) with a mean age of 9.47 ± 7.38 years (mean ± SD) met inclusion criteria. Thirty-two central vascular stents were evaluated. Mean quality score was 2.07 ± 0.94 with 12.5% (4/32) of the cases classified as unevaluable. Interobserver agreement was excellent (k = 0.86). There is no significant difference between quality score and stent location (p = 0.07). There is a significant difference with stent material as all non-diagnostic scores were only seen in covered stents made of platinum-iridium (p < 0.001). There was no association between image quality and age, height, weight, BSA, heart rate, radiation dose or stent lumen size (p > 0.05). ECG-triggered high-pitch spiral DS-CTA offers appropriate image quality for assessment of central vascular stents in children.

Keywords: Cardiac CT; Children; Dual-source CT; ECG-triggered; High Pitch; Stent.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Age Factors
  • Cardiac-Gated Imaging Techniques* / adverse effects
  • Child
  • Child, Preschool
  • Computed Tomography Angiography / adverse effects
  • Computed Tomography Angiography / methods*
  • Electrocardiography*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Peripheral Arterial Disease / diagnostic imaging
  • Peripheral Arterial Disease / physiopathology
  • Peripheral Arterial Disease / surgery*
  • Predictive Value of Tests
  • Prosthesis Design
  • Radiation Dosage*
  • Radiation Exposure* / adverse effects
  • Radiographic Image Interpretation, Computer-Assisted
  • Reproducibility of Results
  • Retrospective Studies
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Young Adult