In:
Journal of Thoracic Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 31, No. 3 ( 2016-05), p. 177-182
Abstract:
We evaluated a high-pitch, non–electrocardiogram-gated cardiac computed tomographic protocol, designed to image both cardiac and extracardiac structures, including coronary arteries, in a neonatal population (less than 1 year old) that was referred for congenital heart disease assessment and compared it with an optimized standard-pitch protocol in an equivalent cohort. Materials and Methods: Twenty-nine high-pitch scans were compared with 31 age-matched, sex-matched, and weight-matched standard-pitch, dosimetrically equivalent scans. The visualization and subjective quality of both cardiac and extracardiac structures were scored by consensus between 2 trained blinded observers. Image noise, signal-to-noise and contrast-to-noise ratios, and radiation doses were also compared. Results: The high-pitch protocol better demonstrated the pulmonary veins ( P =0.03) and all coronary segments (all P 〈 0.05), except the distal right coronary artery ( P =0.10), with no significant difference in the visualization of the remaining cardiac or extracardiac structures. Both contrast-to-noise and signal-to-noise ratios improved due to greater vessel opacity, with significantly fewer streak ( P 〈 0.01) and motion ( P 〈 0.01) artifacts. Image noise and computed tomographic dose index were comparable across the 2 techniques; however, the high-pitch acquisition resulted in a small, but statistically significant, increase in dose-length product [13.0 mGy.cm (9.0 to 17.3) vs. 11.0 mGy.cm (9.0 to 13.0), P =0.05] due to greater z-overscanning. Conclusions: In neonates, a high-pitch protocol improves coronary artery and pulmonary vein delineation compared with the standard-pitch protocol, allowing a more comprehensive assessment of cardiovascular anatomy while obviating the need for either patient sedation or heart rate control.
Type of Medium:
Online Resource
ISSN:
0883-5993
DOI:
10.1097/RTI.0000000000000201
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2016
detail.hit.zdb_id:
2048799-X
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