Non-ECG-triggered dual-source CTA in children with CHD

Abstract

Abstract Objective: To explore the value of non-electrocardiogram-triggered(non-ECG-triggered) on third-generation dual-source CT application in children with congenital heart disease (CHD) in a high heart rate. Methods:Data on children with CHD received cardiac CT angiography (CTA) were collected between November 2019 and March 2021. CT images were obtained using two different protocols: non-ECG-triggeredand retrospectively-ECG-triggered (retro-ECG-triggered). All children received transthoracic echocardiography (TTE) before surgery . Sex, age, weight, heart rate, volume CT dose index (CTDI vol), and dose length product (DLP) were recorded, and the effective dose (ED) was calculated. Image quality was rated using five-point Likert scales and the diagnostic values of CTA and TTE were compared. Results:Children’s age ranged from 1 day to 34 months, with minimum and maximum heart rates of 90 bpm and 160 bpm. There were significant differences between the retro- and non-ECG-triggered groups in the average tube current (54.95±23.52 vs. 45.47±24.65 mAs, p=0.003), CTDI vol (2.41±1.6 vs. 0.58±0.27 mGy, p<0.001), DLP (44.43±34.65 vs. 9.92±5.48 mGy.cm, p<0.001), and ED (1.48±0.90 vs. 0.35±0.17 mSv, p<0.001). There was no difference between the two protocols in the demonstration of extracardiac and intracardiac malformations (all p≥0.05). The diagnostic accuracy of both retro- and non- ECG triggering in intracardiac and extracardiac malformations were high with no significant differences (p=1.00, 0.80). The diagnostic advantage of TTE is mainly in intracardiac malformations (p=0.03, 0.01). Conclusions: High-pitch non-ECG-triggered CTA cansignificantly reduce radiation dose,whereas there was no significant difference in image quality and diagnostic accuracy between non- and retro-ECG-triggered CTA.