B Kelly Han1, David M Overman2, Katharine Grant3, Kristi Rosenthal4, Stephanie Rutten-Ramos4, David Cook4, John R Lesser4. 1. The Children's Heart Clinic at The Children's Hospitals and Clinics of Minnesota, 2530 Chicago Ave South, Suite 500, Minneapolis, MN 55404, USA; The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA. Electronic address: khan@chc-pa.org. 2. The Children's Heart Clinic at The Children's Hospitals and Clinics of Minnesota, 2530 Chicago Ave South, Suite 500, Minneapolis, MN 55404, USA. 3. Siemens Healthcare. 4. The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA.
Abstract
BACKGROUND: Neonates with complex congenital heart disease (CHD) are at risk of adverse events from anesthesia. CT angiography (CTA) performed free breathing and without sedation has not been reported for evaluation of complex CHD in neonates. OBJECTIVES: The aim was to evaluate the image quality and risk of free breathing, non-sedated cardiac CTA for definition of CHD in the neonatal period and to determine accuracy compared with interventional findings. METHODS: This is a combined retrospective-prospective single institution review of all non-sedated, free breathing cardiac CT angiograms performed in patients <1 month of age with complex CHD. Diagnosis, scan acquisition parameters, image quality (1- to 4-point scale), adverse events, radiation dose estimates, and accuracy compared with operative and interventional catheterization findings were recorded. Results are reported as median and interquartile range. RESULTS: Nineteen non-sedated, free breathing, neonatal cardiac CT angiograms were performed during the time of review. All studies were diagnostic with a mean image quality score of 1.1 ± 0.3. Median total procedural dose-length product was 11 (range, 10-14), CT dose index volume was 0.47 (range, 0.31-0.5). Median unadjusted radiation dose was 0.15 mSv (range, 0.14-0.2 mSv), age- and size-adjusted radiation dose was 0.86 mSv (range, 0.78-1.1 mSv). No adverse events and no discrepancies compared with surgical or catheterization findings were found in the 17 of 19 patients that had subsequent intervention. CONCLUSIONS: Cardiac CTA can be performed in the neonatal period free breathing and without sedation. Image quality is excellent, and there is high accuracy compared with surgical and catheterization findings at the time of intervention.
BACKGROUND: Neonates with complex congenital heart disease (CHD) are at risk of adverse events from anesthesia. CT angiography (CTA) performed free breathing and without sedation has not been reported for evaluation of complex CHD in neonates. OBJECTIVES: The aim was to evaluate the image quality and risk of free breathing, non-sedated cardiac CTA for definition of CHD in the neonatal period and to determine accuracy compared with interventional findings. METHODS: This is a combined retrospective-prospective single institution review of all non-sedated, free breathing cardiac CT angiograms performed in patients <1 month of age with complex CHD. Diagnosis, scan acquisition parameters, image quality (1- to 4-point scale), adverse events, radiation dose estimates, and accuracy compared with operative and interventional catheterization findings were recorded. Results are reported as median and interquartile range. RESULTS: Nineteen non-sedated, free breathing, neonatal cardiac CT angiograms were performed during the time of review. All studies were diagnostic with a mean image quality score of 1.1 ± 0.3. Median total procedural dose-length product was 11 (range, 10-14), CT dose index volume was 0.47 (range, 0.31-0.5). Median unadjusted radiation dose was 0.15 mSv (range, 0.14-0.2 mSv), age- and size-adjusted radiation dose was 0.86 mSv (range, 0.78-1.1 mSv). No adverse events and no discrepancies compared with surgical or catheterization findings were found in the 17 of 19 patients that had subsequent intervention. CONCLUSIONS: Cardiac CTA can be performed in the neonatal period free breathing and without sedation. Image quality is excellent, and there is high accuracy compared with surgical and catheterization findings at the time of intervention.
Authors: Cynthia K Rigsby; Sarah E McKenney; Kevin D Hill; Anjali Chelliah; Andrew J Einstein; B Kelly Han; Joshua D Robinson; Christina L Sammet; Timothy C Slesnick; Donald P Frush Journal: Pediatr Radiol Date: 2018-01-01
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