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应用低剂量心脏 CT 评价婴幼儿复杂型先天性心脏病。

Evaluation of complex congenital heart disease in infants using low dose cardiac computed tomography.

机构信息

Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Medical School at Houston/McGovern Medical School at UTHealth, 6410 Fannin Street, Suite 425, Houston, TX, 77030, USA.

出版信息

Int J Cardiovasc Imaging. 2021 Apr;37(4):1455-1460. doi: 10.1007/s10554-020-02118-7. Epub 2021 Jan 3.

Abstract

Despite advances in new CT techniques with radiation dose reduction, there are limited studies describing radiation dose. Describing radiation dose might help to educate physicians on how the benefit of cardiac CT outweighs the potential risk of radiation. The aim of this study was to describe the radiation exposure parameters in newborns and infants and the role of CT scan in providing useful information for optimal surgical planning and management of newborns and infants with complex congenital heart disease. In complex congenital heart disease delineating the anatomy and using the CT images as needed for three-dimensional modelling helps for optimal surgical planning. This single center, retrospective study included 74 infants with CHD (median age 2 months, range 1 day to 9 months) who underwent cardiac CT evaluation from September 2018 to April 2019, using the Siemens Somatom Definition Edge scanner. Total dose length product (DLP) and computed tomographic dose index volume (CTDIvol) were recorded, and the estimated effective radiation dose was calculated using a previously published conversion rate. Median effective radiation dose for the computed tomographic angiography (CTA) was 0.6 mSv. The median DLP was 13 mGycm and median CTDIvol was 3.5 mGy. Cardiac CT can be done with a sub-mSv dose in infants. Cardiac CT completes the standard initial evaluation of neonates and infants with complex CHD, allowing thorough understanding of complex spatial relationships between anatomical and defective structures, and is achievable with minimal radiation exposure.

摘要

尽管新的 CT 技术在降低辐射剂量方面取得了进展,但描述辐射剂量的研究有限。描述辐射剂量可以帮助医生了解心脏 CT 的益处如何超过辐射的潜在风险。本研究旨在描述新生儿和婴儿的辐射暴露参数,以及 CT 扫描在为复杂先天性心脏病新生儿和婴儿提供有用信息以进行最佳手术规划和管理方面的作用。在复杂先天性心脏病中,描绘解剖结构并根据需要使用 CT 图像进行三维建模有助于进行最佳手术规划。这项单中心回顾性研究纳入了 2018 年 9 月至 2019 年 4 月期间接受心脏 CT 评估的 74 例患有 CHD 的婴儿(中位年龄 2 个月,范围 1 天至 9 个月),使用的是西门子 Somatom Definition Edge 扫描仪。记录了总剂量长度产品(DLP)和计算机断层扫描剂量指数体积(CTDIvol),并使用之前发表的转换率计算了估计的有效辐射剂量。CT 血管造影(CTA)的有效辐射剂量中位数为 0.6 mSv。中位数 DLP 为 13 mGycm,中位数 CTDIvol 为 3.5 mGy。婴儿的心脏 CT 可以以亚毫西弗剂量进行。心脏 CT 完成了复杂 CHD 新生儿和婴儿的标准初始评估,使人们能够全面了解解剖结构和缺陷结构之间复杂的空间关系,并且可以在最小的辐射暴露下实现。

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