Application of prospective ECG-gated high-pitch 128-slice dual-source CT angiography in the diagnosis of congenital extracardiac vascular anomalies in infants and children

Pei Nie; Guangjie Yang; Ximing Wang; Yanhua Duan; Wenjian Xu; Haiou Li; Ting Cao; Xuejun Liu; Xiaopeng Ji; Zhaoping Cheng; Anbiao Wang

doi:10.1371/journal.pone.0115793

Application of prospective ECG-gated high-pitch 128-slice dual-source CT angiography in the diagnosis of congenital extracardiac vascular anomalies in infants and children

PLoS One. 2014 Dec 29;9(12):e115793. doi: 10.1371/journal.pone.0115793. eCollection 2014.

Authors

Pei Nie¹, Guangjie Yang², Ximing Wang³, Yanhua Duan³, Wenjian Xu¹, Haiou Li³, Ting Cao³, Xuejun Liu¹, Xiaopeng Ji³, Zhaoping Cheng³, Anbiao Wang⁴

Affiliations

¹ Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
² Department of Nuclear Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China.
³ Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong, China.
⁴ Department of Cardiovascular Surgery, Shandong Provincial Hospital, Jinan, Shandong, China.

Abstract

Purpose: To investigate the value of prospective ECG-gated high-pitch 128-slice dual-source CT (DSCT) angiography in the diagnosis of congenital extracardiac vascular anomalies in infants and children in comparison with transthoracic echocardiography (TTE).

Methods: Eighty consecutive infants or children clinically diagnosed of congenital heart disease and suspected with extracardiac vascular anomaly were enrolled, and 75 patients were finally included in this prospective study. All patients underwent prospective ECG-gated high-pitch DSCT angiography after TTE with an interval of 1-7 days. The diagnostic accuracy and sensitivity of high-pitch DSCT angiography and TTE were compared according to the surgical/CCA findings. The image quality of DSCT was assessed using a five-point scale. The effective radiation dose (ED) was calculated.

Results: A total of 17 congenital heart diseases and 162 separate extracardiac vascular anomalies were confirmed by surgical/CCA findings in 75 patients. The diagnostic accuracy of high-pitch DSCT angiography and TTE was 99.67% and 97.89%, respectively. The sensitivity of high-pitch DSCT angiography and TTE was 97.53% and 79.62%, respectively. There was significant difference regarding to the diagnostic accuracy and the sensitivity between high-pitch DSCT angiography and TTE (χ2 = 23.561 and 28.013, P<0.05). The agreement on the image quality scoring of DSCT between the two observers was excellent (κ = 0.81), and the mean score of image quality was 4.1±0.7. The mean ED of DSCT was 0.29±0.08 mSv.

Conclusions: Prospective ECG-gated high-pitch 128-slice DSCT angiography with low radiation dose and high diagnostic accuracy has higher sensitivity compared to TTE in the detection of congenital extracardiac vascular anomalies in infants and children.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
Coronary Angiography / methods
Echocardiography / methods
Electrocardiography / methods
Female
Heart Defects, Congenital / diagnosis*
Humans
Infant
Male
Prospective Studies
Radiation Dosage
Vascular Malformations / diagnosis*

Grants and funding

This study was supported by grants from the Natural Science Foundation of Shandong Province (Liu X, ZR2011HQ022). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.