Duan Yan-hua, Wang Xi-ming, Cheng Zhao-ping, Wu Da-wei, Wu Le-bin
Shandong Medical Imaging Research Institute, Medical School of Shandong University, Jinan 250021, China.
Zhonghua Yi Xue Za Zhi. 2012 Jan 17;92(3):179-83.
To explore the application of prospective ECG-triggering dual-source CT (DSCT) angiography in infants and children with complex congenital heart disease (CHD) compared with transthoracic echocardiography (TTE).
Eighty-seven patients (mean age: 28 months, range 3 months to 6 years; male 46; mean weight: 15 kg) underwent prospective ECG-triggering DSCT angiography and TTE. Surgery was performed in 54 patients. The overall imaging quality was evaluated on a four-point scale. Inter-observer agreement in subjective image quality grading was assessed by kappa statistics. The accuracy of DSCT angiography and TTE was calculated based on the surgery findings in the 54 patients who were performed with surgery.
A total of 267 cardiovascular deformities were diagnosed by DSCT angiography, and 231 deformities were diagnosed by TTE. There was a good agreement on overall image quality (kappa = 0.78). A total of 173 cardiovascular deformities were confirmed by surgery findings in 54 patients. The accuracy of DSCT angiography and TTE was 97.69% (169/173) and 82.08% (142/173). The mean effective dose was (0.40 ± 0.08) mSv.
Prospective ECG-triggering DSCT angiography with a very low effective radiation dose allows the accurate diagnosis of anomalies in infants and children with complex CHD compared with TTE. It has great value for preoperative assessment of CHD.
探讨前瞻性心电图触发双源CT(DSCT)血管造影在婴幼儿复杂先天性心脏病(CHD)中的应用,并与经胸超声心动图(TTE)进行比较。
87例患者(平均年龄:28个月,范围3个月至6岁;男性46例;平均体重:15 kg)接受了前瞻性心电图触发DSCT血管造影和TTE检查。54例患者接受了手术治疗。整体影像质量采用四分制进行评估。通过kappa统计评估主观图像质量分级中观察者间的一致性。基于54例接受手术患者的手术结果计算DSCT血管造影和TTE的准确性。
DSCT血管造影共诊断出267处心血管畸形,TTE诊断出231处畸形。整体图像质量具有良好的一致性(kappa = 0.78)。54例患者的手术结果共证实了173处心血管畸形。DSCT血管造影和TTE的准确性分别为97.69%(169/173)和82.08%(142/173)。平均有效剂量为(0.40±0.08)mSv。
与TTE相比,前瞻性心电图触发DSCT血管造影有效辐射剂量极低,能够准确诊断婴幼儿复杂CHD的异常情况。对CHD术前评估具有重要价值。