Thorac Cardiovasc Surg 2014; 62(03): 203-210
DOI: 10.1055/s-0033-1349791
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Dual Source Computed Tomography in Patients with Congenital Heart Disease

Susanne Ihlenburg
1   Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany
,
Oliver Rompel
2   Division of Pediatric Radiology, University Hospital Erlangen, Erlangen, Germany
,
Andre Rueffer
1   Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany
,
Ariawan Purbojo
1   Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany
,
Robert Cesnjevar
1   Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany
,
Sven Dittrich
3   Department of Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany
,
Martin Gloeckler
3   Department of Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany
› Author Affiliations
Further Information

Publication History

09 February 2013

10 June 2013

Publication Date:
29 August 2013 (online)

Abstract

Objectives The objective of this study was to review our early experience with the dual source computed tomography (DSCT), a recently available scanner technique equipped with two X-ray tubes and two detectors, in the context of congenital cardiac malformations.

Patients and Methods We reviewed 40 pediatric patients with congenital heart disease (CHD) who underwent DSCT between September 2009 and December 2011 as diagnostic imaging tool for surgical procedures.

Results The median age was 0.36 years (range: 3 days to 44 years). Great vessels (n = 13), cardiac anatomy (n = 13), trachea and vascular rings (n = 7), pulmonary veins (n = 4), and coronary arteries (n = 3) were focused on, which revealed important information for surgery. Scanning quality was affected in only two cases (metal artifacts and tachycardia). Overall median age-specific dose was 1.47 mSv. In patients younger than 1 year (n = 26), median dose was 1.28 mSv.

Conclusion DSCT allows a very rapid scan speed, examinations are performed in spontaneously breathing patients, and the radiation exposure is relatively low. It is very valuable in the setting of complex surgery by revealing the position of anatomical structures in their relation to each other. Missing information can be acquired less invasively in addition to echocardiography and might replace cardiac catheterization for several morphological indications.

 
  • References

  • 1 Haramati LB, Glickstein JS, Issenberg HJ, Haramati N, Crooke GA. MR imaging and CT of vascular anomalies and connections in patients with congenital heart disease: significance in surgical planning. Radiographics 2002; 22 (2) 337-347 , discussion 348–349
  • 2 Mehta R, Lee KJ, Chaturvedi R, Benson L. Complications of pediatric cardiac catheterization: a review in the current era. Catheter Cardiovasc Interv 2008; 72 (2) 278-285
  • 3 Chan FP. MR and CT imaging of the pediatric patient with structural heart disease. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2009; 12 (1) 99-105
  • 4 Samyn MM. A review of the complementary information available with cardiac magnetic resonance imaging and multi-slice computed tomography (CT) during the study of congenital heart disease. Int J Cardiovasc Imaging 2004; 20 (6) 569-578
  • 5 Dillman JR, Hernandez RJ. Role of CT in the evaluation of congenital cardiovascular disease in children. AJR Am J Roentgenol 2009; 192 (5) 1219-1231
  • 6 Bailliard F, Hughes ML, Taylor AM. Introduction to cardiac imaging in infants and children: techniques, potential, and role in the imaging work-up of various cardiac malformations and other pediatric heart conditions. Eur J Radiol 2008; 68 (2) 191-198
  • 7 Ait-Ali L, Andreassi MG, Foffa I, Spadoni I, Vano E, Picano E. Cumulative patient effective dose and acute radiation-induced chromosomal DNA damage in children with congenital heart disease. Heart 2010; 96 (4) 269-274
  • 8 Achenbach S, Marwan M, Ropers D , et al. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J 2010; 31 (3) 340-346
  • 9 Petersilka M, Bruder H, Krauss B, Stierstorfer K, Flohr TG. Technical principles of dual source CT. Eur J Radiol 2008; 68 (3) 362-368
  • 10 Lell MM, May M, Deak P , et al. High-pitch spiral computed tomography: effect on image quality and radiation dose in pediatric chest computed tomography. Invest Radiol 2011; 46 (2) 116-123
  • 11 Deak PD, Smal Y, Kalender WA. Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product. Radiology 2010; 257 (1) 158-166
  • 12 Goo HW, Seo DM, Yun TJ , et al. Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multislice CT findings. Pediatr Radiol 2009; 39 (3) 265-273
  • 13 Kuettner A, Gehann B, Spolnik J , et al. Strategies for dose-optimized imaging in pediatric cardiac dual source CT. Rofo 2009; 181 (4) 339-348
  • 14 Ben Saad M, Rohnean A, Sigal-Cinqualbre A, Adler G, Paul JF. Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease. Pediatr Radiol 2009; 39 (7) 668-676
  • 15 Goo HW. State-of-the-art CT imaging techniques for congenital heart disease. Korean J Radiol 2010; 11 (1) 4-18
  • 16 Justino H. The ALARA concept in pediatric cardiac catheterization: techniques and tactics for managing radiation dose. Pediatr Radiol 2006; 36 (Suppl. 02) 146-153
  • 17 Bacher K, Bogaert E, Lapere R, De Wolf D, Thierens H. Patient-specific dose and radiation risk estimation in pediatric cardiac catheterization. Circulation 2005; 111 (1) 83-89
  • 18 Yakoumakis EN, Gialousis GI, Papadopoulou D , et al. Estimation of children's radiation dose from cardiac catheterisations, performed for the diagnosis or the treatment of a congenital heart disease using TLD dosimetry and Monte Carlo simulation. J Radiol Prot 2009; 29 (2) 251-261