Yan Wang MMed, MS, Presenter: Nothing to Disclose

Dapeng Shi MD, Abstract Co-Author: Nothing to Disclose

To explore the application of dual source CT with ultra-low tube voltage (70kV)  combined with iterative reconstruction algorithm (SAFIRE) in infants with total anomalous pulmonary venous connections.

This prospective study was approved by institutional review board, and written informed consents were obtained from all patients’ parents. Twenty three infants (13 male and 10 female, mean age 3 months, range 1-36 months, mean weight 5kg) suspected of total anomalous pulmonary venous connections (TAPCV) in our hospital, underwent cardiovascular examination with DSCT and trans-thoracic echocardiography (TTE) one week before surgery. All DSCT scans used the Flash mode with a tube voltage of 70 kV, and the tube current, amount of contrast medium and injection rate were adjusted according to patients’ weight. Images were reconstructed with iterative reconstruction algorithm SAFIRE. DSCT and TTE results were compared with the results from surgery. Image quality was evaluated, and effective radiation dose (ED) was calculated.

All 23 cases were confirmed as TAPVA in operations. DSCT diagnosed all 23 cases, TTE missed 1 case; however 22 cases were diagnosed correctly as TAPVA with DSCT except one mixed type case, 16 cases were diagnosed correctly with TTE, and 3 mixed type cases were misdiagnosed, 3 infracardiac were diagnosed when information from CT was considered. Seventy three anomalous pulmonary veins were identified by DSCT, which results in a detection rate of 91.6%(73/76); 65 were identified by TTE, with a detection rate of 85.5%(65/76); 39 combined malformations were detected by DSCT among all 41 malformations from surgery, with a detection rate of 95.1%(39/41), 40 combined malformations were detected by TTE, with a detection rate of 97.6%(40/41). For DSCT scans, image quality was good or excellent for 21 patients and diagnostic in 2 patients. The mean effective radiation dose ED was (0.95 ± 0.32) mSv.

DSCT Flash mode scans with combination of 70kV tube voltage technique and SAFIRE reconstruction algorithm can compensate for move artefacts caused by the rapid heart rate and free breathing in infants, improve the image quality, and perform CT examination with low radiation dose and less contrast medium.

Flash mode on DSCT with a combination of 70kV tube voltage and iterative reconstruction algorithm SAFIRE has a good performance in infants with complicated TAPVC.  

Wang, Y, Shi, D, The Application of 70 kV Technique Combined with Sinogram Affirmed Iterative Reconstruction (SAFIRE) in Infants with Total Anomalous Pulmonary Venous Connections: An Experimental Study with Dual-Source CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013278.html