Sun Minghua,Pan Yukun,Wen Ru,Zhang Jiliang,Xie Ruigang,Ge Yinghui.Clinical value of prospective ECG-gated high-pitch CT scanning in the diagnosis of pediatric congenital heart disease[J].Chinese Journal of Radiological Medicine and Protection,2024,44(3):228-232
Clinical value of prospective ECG-gated high-pitch CT scanning in the diagnosis of pediatric congenital heart disease
Received:June 19, 2023  
DOI:10.3760/cma.j.cn112271-20230619-00200
KeyWords:Heart defects, congenital  Tomography, X-ray computed  Dual-source CT  Radiation dose
FundProject:河南省医学科技攻关计划联合共建项目(LHGJ20220123)
Author NameAffiliationE-mail
Sun Minghua Department of Radiology, Fuwai Central China Cardiovascular Hospital, Key Laboratory of Cardiology Radiology of Henan Province, Zhengzhou 451464, China  
Pan Yukun Department of Radiology, Fuwai Central China Cardiovascular Hospital, Key Laboratory of Cardiology Radiology of Henan Province, Zhengzhou 451464, China  
Wen Ru Department of Radiology, Fuwai Central China Cardiovascular Hospital, Key Laboratory of Cardiology Radiology of Henan Province, Zhengzhou 451464, China  
Zhang Jiliang Department of Radiology, Fuwai Central China Cardiovascular Hospital, Key Laboratory of Cardiology Radiology of Henan Province, Zhengzhou 451464, China  
Xie Ruigang Department of Radiology, Fuwai Central China Cardiovascular Hospital, Key Laboratory of Cardiology Radiology of Henan Province, Zhengzhou 451464, China  
Ge Yinghui Department of Radiology, Fuwai Central China Cardiovascular Hospital, Key Laboratory of Cardiology Radiology of Henan Province, Zhengzhou 451464, China cjr.geyinghui@vip.163.com 
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Abstract::
      Objective To investigate the clinical value of prospective ECG-gated high-pitch protocol scanning of third generation DSCT in the diagnosis of pediatric congenital heart disease (CHD). Methods A total of 243 children with confirmed CHD who were expected to undergo surgical treatment were prospectively collected and randomly divided evenly into 3 groups, with first group for prospective ECG-gated high-pitch scanning in third generation DSCT (Flash3rd), second group for prospective ECG-gated high-pitch scanning in second generation DSCT (Flash2nd) and third group for prospective sequential scanning in third generation DSCT (Sequence3rd). The SD value and SNR of aortic root and pulmonary artery of each child were recorded. The 5-point system is adopted with subjective scoring. Based on the result of operation, the diagnosis accuracy in 3 groups was analyzed. Results The E values in Flash3rd, Flash2nd and Sequence3rd group were 0.24 (0.19, 0.27), 0.11 (0.10, 0.14) and 0.44 (0.39, 0.48) mSv (H=207.04, P<0.05), respectively. Subjective scores of group Flash3rd and Sequence3rd were significantly higher than that of group Flash2nd [4 (4, 4) vs. 4(3, 4) vs. 3(3, 3), H=124.05, P<0.05] and no difference between these two groups. SD value of aortic root and pulmonary artery of group Flash3rd and Sequence3rd were significantly lower than that of group Flash2nd(H= -40.27-33.38,P<0.05). SNR of aortic root and pulmonary artery of group Flash3rd was significantly higher than that of group Flash2nd and Sequence3rd (H=-0.90-51.42, P<0.05). Diagnosis accuracy of intracardiac malformation for group Flash2nd was significantly lower than that of Flash3rd and Sequence3rd (77.7%, 90.9%, 88.9%, K=9.36, P<0.05), and there was no significant difference between the latter two groups. There was no difference in diagnosis accuracy of extracardiac malformation among 3 groups (88.6%, 94.8%, 92.2%, K=3.11, P=0.21). Conclusions The prospective ECG-gated high-pitch scanning in third generation DSCT can take into account radiation dose and image quality, which has important clinical value in the diagnosis of CHD.
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