Roik Danuta, Kucińska Beata, Roik Marek, Werner Bożena
Department of Pediatric Radiology, Pediatric Teaching Clinical Hospital, Medical University of Warsaw, Warsaw, Poland.
Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warszawa, Poland.
Kardiol Pol. 2022;80(5):567-574. doi: 10.33963/KP.a2022.0088. Epub 2022 Apr 2.
Diagnostic imaging of coronary arteries is required in neonates and infants suspected of congenital or acquired coronary artery anomalies and in pre- and postoperative assessment of complex congenital heart diseases (CHD).
Our study aimed to evaluate the image quality of volumetric 320-row computed tomography angiography (CTA) with prospective electrocardiogram (ECG)-gating for coronary arteries in neonates and infants with heart diseases, analyze factors influencing image quality and assess a radiation dose related to the procedure.
The study included 110 CTA performed in neonates and infants with CHD.
CTA was performed in 37 girls and 73 boys at a median (interquartile range [IQR]) age of 3.0 (0.5-5.0) months, median (IQR) body weight of 5 (3.66-6.5) kg, and median heart rate (HR) of 133 (92-150) beats per minute. The orifices of the left coronary artery were visible in 100% of CTA, the orifices of the right coronary arteries were visible in 96%, whereas all coronary segments were assessable in 45% of CTA. Patients with non-diagnostic segments were significantly younger, median (IQR) age of 2.0 (0.21-5.00) months, had lower body weight of 4.6 (3.45-6.07) kg and faster HR of 136.5 (120-150) beats per minute (P <0.05) than patients with diagnostic image quality in all segments (4.0, 2-6 months, 6.0, 4.2-7 kg, and 130; 110-150 beats per minute, respectively; P <0.05).
CTA performed with volumetric 320-row prospective ECG-gating allows for good visibility of the coronary arteries with an acceptable radiation dose. Children aged >15 days, with body weight >4.85 kg and HR <130 beats per minute are good candidates for excellent quality non-invasive CTA of all segments of coronary arteries.
对于怀疑患有先天性或后天性冠状动脉异常的新生儿和婴儿，以及复杂先天性心脏病（CHD）的术前和术后评估，都需要进行冠状动脉的诊断性成像。
我们的研究旨在评估采用前瞻性心电图（ECG）门控的容积320排计算机断层扫描血管造影（CTA）对患有心脏病的新生儿和婴儿冠状动脉的图像质量，分析影响图像质量的因素，并评估与该检查相关的辐射剂量。
该研究纳入了对患有CHD的新生儿和婴儿进行的110次CTA检查。
对37名女孩和73名男孩进行了CTA检查，中位（四分位间距[IQR]）年龄为3.0（0.5 - 5.0）个月, 中位（IQR）体重为5（3.66 - 6.5）kg，中位心率（HR）为每分钟133（92 - 150）次。100%的CTA可见左冠状动脉口，96%可见右冠状动脉口，而45%的CTA可评估所有冠状动脉节段。与所有节段图像质量可诊断的患者相比，节段诊断不清的患者明显更年幼，中位（IQR）年龄为2.0（0.21 - 5.00）个月，体重更低，为4.6（3.45 - 6.07）kg，心率更快，为每分钟136.5（120 - 150）次（P <0.05）（所有节段图像质量可诊断的患者年龄分别为4.0、2 - 6个月，体重6.0、4.2 - 7 kg，心率130、110 - 150次/分钟；P <0.05）。
采用容积320排前瞻性ECG门控进行CTA检查，可在可接受的辐射剂量下使冠状动脉具有良好的可视性。年龄大于15天、体重>4.85 kg且心率<130次/分钟的儿童是进行所有冠状动脉节段高质量无创CTA检查的良好对象。
