Barrera Christian A, Otero Hansel J, White Ammie M, Saul David, Biko David M
Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA..
Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA.
Curr Probl Diagn Radiol. 2020 Jan-Feb;49(1):23-28. doi: 10.1067/j.cpradiol.2018.10.006. Epub 2018 Oct 29.
Evaluate the feasibility and determinants of image quality of ECG-triggered High-Pitch Dual-Source Computed Tomography Angiography (CTA) for cardiovascular assessment in Children.
All children that underwent ECG-triggered High-Pitch Dual-Source CTA between August 2014 and September 2017 were identified. Scanner parameters and patients' information were retrieved. Objective image quality was evaluated measuring the Hounsfield units (HU) and standard deviation of regions of interests in the left ventricle, ascending and descending aorta. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Qualitative image quality was recorded independently by two pediatric radiologist blinded using a three-point scale: 1 - good image quality, 2 - mild artifacts, 3 - poor image quality. Continuous variables were presented as mean ± standard deviation. The interobserver agreement and non-parametric test were used.
93 patients (mean age 5.6 ± 7.1 years) were selected. Average cardiovascular attenuation, SNR and CNR were 406.2 ± 146.3 HU, 24.2 ± 16.0 HU and 52.1 ± 38.6 HU, respectively. Average image quality was 1.51 ± 0.48 and the inter-observer agreement was excellent (k = 0.8). Worse subjective quality scores were associated with lower age, height, weight, BSA, lower contrast dose and slower injection rates (p < 0.05). Higher heart rate was associated with high attenuation (p < 0.05), however, SNR and CNR did not show an association with heart rate (p = 0.80).
ECG-triggered High-Pitch Dual-Source cardiac CTA is feasible and provides good or excellent image quality for the evaluation of cardiovascular diseases in children.
评估心电图触发的高螺距双源计算机断层血管造影（CTA）用于儿童心血管评估的可行性及图像质量的决定因素。
确定2014年8月至2017年9月期间接受心电图触发的高螺距双源CTA检查的所有儿童。检索扫描参数和患者信息。通过测量左心室、升主动脉和降主动脉感兴趣区域的Hounsfield单位（HU）和标准差来评估客观图像质量。计算信噪比（SNR）和对比噪声比（CNR）。由两名儿科放射科医生采用三点量表独立记录定性图像质量：1 - 图像质量良好，2 - 轻度伪影，3 - 图像质量差。连续变量以平均值±标准差表示。采用观察者间一致性检验和非参数检验。
选取93例患者（平均年龄5.6±7.1岁）。平均心血管衰减、SNR和CNR分别为406.2±146.3 HU、24.2±16.0 HU和52.1±38.6 HU。平均图像质量为1.51±0.48，观察者间一致性良好（k = 0.8）。较差的主观质量评分与较低的年龄、身高、体重、体表面积、较低的对比剂剂量和较慢的注射速率相关（p < 0.05）。较高的心率与高衰减相关（p < 0.05），然而，SNR和CNR与心率无相关性（p = 0.80）。
心电图触发的高螺距双源心脏CTA是可行的，为评估儿童心血管疾病提供了良好或优异的图像质量。
