Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease

Background: There are only a few reports on the diagnostic accuracy, and the technical and clinical feasibility, of multidetector CT (MDCT) in infants with congenital heart disease (CHD). Objective: To evaluate the image quality and radiation dose of DSCT in babies with CHD. Materials and methods: From November 2006 to November 2007, 110 consecutive infants with CHD referred for pre- or postoperative CT evaluation were included. All these infants had a spiral angiothoracic DSCT scan after injection of 300 mg/ml iopromide at 0.5–1 ml/s with a power injector using a low-dose protocol (80 kVp and 10 mAs/kg). Of these infants, 34 also underwent an ECG-gated coronary CT scan for evaluation of the course of the coronary arteries. Results: No serious adverse events were recorded. The mean dose-length product was 8±6 mGy.cm (effective dose 0.5±0.2 mSv) and 21±9 mGy.cm (effective dose 1.3±0.6 mSv) during the non-ECG-gated spiral acquisition and ECG-gated acquisition, respectively. Diagnostic quality images were achieved with the spiral acquisition in 89% of cases. Compared to the spiral mode, ECG-gated acquisition significantly improved the visualization of the coronary arteries, with a diagnostic rate of 91% and 84% for the left and right coronary arteries, respectively. Conclusion: DSCT together with iopromide at 300 mg/ml is a valuable tool for the routine clinical evaluation of infants with CHD. ECG-gated acquisition provides reliable visualization of the course of the coronary arteries.