Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Japan.
Int J Cardiol. 2012 May 3;156(3):309-14. doi: 10.1016/j.ijcard.2010.11.009. Epub 2010 Dec 15.
To minimize radiation exposure during a multi-slice computed tomography (MSCT) examination in children with congenital heart disease (CHD), we assessed diagnostic value and the various applications of MSCT without electrocardiography (ECG)-gated image acquisition.
Three-dimensional (3D) images were reconstructed to include volume rendering and differential color-coding of the arteries and veins. The vessel diameter in MSCT was measured with CT attenuation profiles and compared with that of angiography. Ventricular volumetry was initially validated by phantom experiment and followed by comparison with that of cine-angiography (n=15). Simulation for surgical operation was performed to evaluate the possibility of an intraventricular conduit in patients diagnosed with a double outlet right ventricle.
Differential color-coding was able to provide accurate and understandable anatomical structure in CHD. The diameter of the descending aorta measured in MSCT correlated well with the values obtained by angiography (r(2)=0.86). According to the results of the phantom experiment, ventricular volume was studied in patients whose heart rate was faster than 120 beat/min. The left and the right ventricular volume in MSCT correlated well with values obtained by cine-angiography (r(2)=0.98 for RV, r(2)=0.94 for LV). Simulative operation of intraventricular rerouting provided appropriate indication for biventricular repair in patients diagnosed with a double outlet right ventricle.
Non-ECG-gated MSCT angiography is applicable for precise anatomical diagnosis, ventricular volumetric study, and simulation surgery in children with CHD.
为了降低先天性心脏病（CHD）患儿多层螺旋 CT（MSCT）检查的辐射剂量，我们评估了非心电门控 MSCT 成像在 CHD 患儿中的诊断价值及其在多方面的应用。
三维（3D）图像重建包括容积再现和动脉静脉的差异彩色编码。MSCT 中的血管直径通过 CT 衰减曲线进行测量，并与血管造影进行比较。心室容积测量首先通过体模实验进行验证，然后与电影血管造影（n=15）进行比较。模拟手术操作评估了在诊断为右心室双出口的患者中进行心室内管道的可能性。
差异彩色编码能够提供 CHD 患者准确且易于理解的解剖结构信息。MSCT 测量的降主动脉直径与血管造影值相关性良好（r(2)=0.86）。根据体模实验的结果，对心率超过 120 次/分的患者进行心室容积研究。MSCT 测量的左、右心室容积与电影血管造影值相关性良好（r(2)=0.98 用于 RV，r(2)=0.94 用于 LV）。心室内改道模拟手术为诊断为右心室双出口的患者的双心室修复提供了合适的手术指征。
非心电门控 MSCT 血管造影适用于 CHD 患儿的精确解剖诊断、心室容积研究和模拟手术。
