Barrera Christian A, Otero Hansel J, White Ammie M, Saul David, Biko David M
Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Int J Cardiovasc Imaging. 2019 Feb;35(2):367-374. doi: 10.1007/s10554-019-01539-3. Epub 2019 Jan 25.
Assess image quality and radiation dose of ECG-triggered High-Pitch Dual-Source CTA for the evaluation central vascular stents in children. We included all children ≤ 21 years old with one or more central vascular stents and available prospective ECG-triggered High-Pitch Dual-Source CTA performed at our institution between January 2015 and August 2017. Demographic and scanner information was retrieved. Two board-certified pediatric radiologists blinded to the clinical data, independently reviewed and scored each case using a four-point quality score. Scores 1, 2 and 3 were considered of diagnostic image quality. Inter-observer agreement and non-parametric test were used. 18 patients (10 girls, 8 boys) with a mean age of 9.47 ± 7.38 years (mean ± SD) met inclusion criteria. Thirty-two central vascular stents were evaluated. Mean quality score was 2.07 ± 0.94 with 12.5% (4/32) of the cases classified as unevaluable. Interobserver agreement was excellent (k = 0.86). There is no significant difference between quality score and stent location (p = 0.07). There is a significant difference with stent material as all non-diagnostic scores were only seen in covered stents made of platinum-iridium (p < 0.001). There was no association between image quality and age, height, weight, BSA, heart rate, radiation dose or stent lumen size (p > 0.05). ECG-triggered high-pitch spiral DS-CTA offers appropriate image quality for assessment of central vascular stents in children.
评估心电图触发的高螺距双源CT血管造影(CTA)在评估儿童中心血管支架时的图像质量和辐射剂量。我们纳入了所有年龄≤21岁、植入一个或多个中心血管支架且于2015年1月至2017年8月在我院接受前瞻性心电图触发高螺距双源CTA检查的儿童。收集人口统计学和扫描仪信息。两名对临床数据不知情的经过委员会认证的儿科放射科医生,使用四分质量评分系统对每个病例进行独立评估和评分。评分1、2和3被认为具有诊断图像质量。采用观察者间一致性分析和非参数检验。18例患者(10名女孩,8名男孩)符合纳入标准,平均年龄为9.47±7.38岁(平均值±标准差)。共评估了32个中心血管支架。平均质量评分为2.07±0.94,其中12.5%(4/32)的病例被归类为不可评估。观察者间一致性极佳(k = 0.86)。质量评分与支架位置之间无显著差异(p = 0.07)。与支架材料存在显著差异,因为所有非诊断性评分仅见于铂铱合金覆膜支架(p < 0.001)。图像质量与年龄、身高、体重、体表面积、心率、辐射剂量或支架管腔大小之间无相关性(p > 0.05)。心电图触发的高螺距螺旋双源CT血管造影为评估儿童中心血管支架提供了合适的图像质量。