Department of Radiology, The Fourth Affiliated Hospital, Harbin Medical University, No 37, Yi Yuan Street, Nan Gang District, Harbin 150001, China.
Int J Cardiovasc Imaging. 2012 Oct;28(7):1787-97. doi: 10.1007/s10554-011-0005-1. Epub 2011 Dec 28.
To investigate the clinical significance of the application of 320-row CT angiography with low-dose prospective ECG-triggered target scanning in children with complex congenital heart disease (CHD), and to compare with the results from transthoracic echocardiography (TTE). 22 patients (male 12 cases, female 10 cases, average age: 18 months, range: 14 days-9 years, average weight: 13 kg) received an examination through 320-row CT angiography with low-dose prospective ECG-triggered volume target scan mode and transthoracic echocardiography. The center of phase window for data collection in this study was set to 40% of the R-R interval. Of these, 18 patients received surgery and 4 patients received conventional cardiac angiography (CCA). 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. Complex congenital heart disease was confirmed by surgical or CCA in each of 22 patients, with 42 cases of large vascular malformations outside the heart cavity, and 26 of intracardiac malformations. The diagnostic accuracy of 320-row CT angiography and transthoracic echocardiography for large vascular malformation outside the heart cavity was 95.2 and 80.9%, respectively; for intracardiac malformation the accuracy was 88.5 and 100.0%, respectively. There was significant difference between 320-row CT and transthoracic echocardiography in the diagnosis of large vascular malformation outside the heart cavity (P < 0.05) with better results in 320-row CT, 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 0.42 ± 0.08 mSv. 320-row CT enables direct visualization of the vascular configuration and shape of the aorta, pulmonary artery, and other large vessels to diagnose extracardiac vascular malformations. Combined with transthoracic echocardiography, 320-row CT is a promising technology that may be able to replace catheter based angiography to evaluate congenital cardiovascular malformations.
探讨低剂量前瞻性心电门控容积触发扫描 320 排 CT 血管成像在复杂先天性心脏病（CHD）患儿中的临床应用价值，并与经胸超声心动图（TTE）结果进行比较。
选取 22 例复杂 CHD 患儿（男 12 例，女 10 例；年龄 18 个月[14 d~9 岁]，平均体重 13 kg），均采用低剂量前瞻性心电门控容积触发扫描模式行 320 排 CT 血管成像检查，采集数据的相位窗中心设定在 R-R 间期的 40%。其中 18 例行手术治疗，4 例行常规心脏导管造影（CCA）。根据手术及/或 CCA 检查结果计算 320 排 CTA 的诊断准确率。将 CTA 图像的总体质量评分分为 5 个等级。并与接受 CT 血管造影的先天性心脏病患者的辐射剂量研究数据进行比较。
22 例患儿均经手术或 CCA 证实为复杂 CHD，合并心外大血管畸形 42 例，合并心内畸形 26 例。320 排 CT 血管成像对心外大血管畸形的诊断准确率为 95.2%，TTE 为 80.9%，两者比较差异有统计学意义（P<0.05），320 排 CT 血管成像对心内畸形的诊断准确率为 88.5%，TTE 为 100.0%，两者比较差异无统计学意义（P>0.05）。主观图像质量评分平均（4.4±0.7）分，有效剂量平均（0.42±0.08）mSv。320 排 CT 可直接显示主动脉、肺动脉及其他大血管的形态及走行，诊断心外大血管畸形。结合 TTE，320 排 CT 血管成像可能成为一种有前途的技术，有望替代导管法血管造影来评估先天性心血管畸形。
