Tong Zhang MD, Presenter: Nothing to Disclose

Zhu-Ren Luo, Abstract Co-Author: Nothing to Disclose

Bao-Zhong Shen, Abstract Co-Author: Nothing to Disclose

To investigate the clinical significance of application of the 320-row CT angiography with low-dose prospective ECG-gated target scan mode in infants with complex congenital heart disease, and to compare with the results from transthoracic echocardiography.

22 patients (average age: 16 months, range: 14 days to 6 years, male 15 cases, average weight 12 kg) received 320-row CT angiography with low-dose prospective ECG-gated volume target scan mode and transthoracic echocardiography examination. The center of phase window for data collection in this study was set to 40% of R-R interval. Of these, 18 patients received surgery, 4 patients received conventional cardiac angiography. The diagnostic accuracy of 320-row CTA was calculated according to the examination results from surgical and/or cardiac angiography. The overall quality score for CTA images was divided into five levels. The results were compared with the research data of radiation doses obtained from patients with congenital heart disease who had received CT angiography.

22 cases of patients had been confirmed by surgical/imaging with 39 of a large vascular malformation outside the heart cavity, and 28 of intracardiac malformation. The diagnostic accuracy of 320-row CT angiography and transthoracic echocardiography for a large vascular malformation outside the heart cavity was 94.8% and 82.1%, respectively; for intracardiac malformation was 89.3% and 100%, respectively. There was significant difference between 320-row CT and transthoracic echocardiography in the diagnosis of a large vascular malformation outside the heart cavity (P <0.05), and no significant difference was found in the diagnosis of intracardiac malformation (P> 0.05). The average subjective image quality score was 4.4 ± 0.7 points. The average effective dose was 0.38 ± 0.09 mSv.

320-row CT can directly display the vascular configuration and shape of the aorta, pulmonary artery and its branches and other large vessels, to provide the objective basis for the diagnosis of the extracardiac large vascular malformation, combined with transthoracic echocardiography, which can replace the angiocardiography for the diagnosis of congenital cardiovascular malformation.

Combined with transthoracic echocardiography, 320-row CT with a very low effective radiation can become the first selective tool for the diagnosis of complex congenital heart disease.

Zhang, T, Luo, Z, Shen, B, Initial Experience on the Application of 320-Row CT Angiography with Low Dose Prospective ECG-gated Volume Target Scan Mode in Infants with Complex Congenital Heart Disease.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006933.html