Application of dual-energy CT with prospective ECG-gating in cardiac CT angiography for children: Radiation and contrast agent dose

作者全名："Xie, Mingye; Wang, Haoru; Tang, Shilong; Chen, Mingjing; Li, Ting; He, Ling"

作者地址："[Xie, Mingye; Wang, Haoru; Tang, Shilong; Li, Ting; He, Ling] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Key Lab Child Dev & Disorders, Childrens Hosp,Minist Educ,Dept Radiol,Chongqing K, Chongqing 400014, Peoples R China; [Chen, Mingjing] Jining 1 Peoples Hosp, Dept Urol, Jining, Peoples R China; [He, Ling] 136 Zhongshan Second Rd, Chongqing, Peoples R China"

通信作者："He, L (通讯作者)，136 Zhongshan Second Rd, Chongqing, Peoples R China."

来源：EUROPEAN JOURNAL OF RADIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001132803500001

JCR分区：Q1

影响因子：3.3

年份：2024

卷号：170

期号：　

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结束页：　

文献类型：Article

关键词：Dual-energy CT; Virtual monoenergetic images; Cardiac CT angiography; Pediatric; Congenital heart disease

摘要："Objective: This research aimed to investigate the feasibility of utilizing dual-energy CT virtual monoenergetic images (VMI1) with prospective electrocardiogram (ECG(2)) gating for reducing radiation and contrast agent doses in pediatric patients with congenital heart disease (CHD3). Methods: There were 100 pediatric patients with CHD included in this study. Group A (n = 50) underwent dual-energy scanning with prospective ECG-gating, and group B (n = 50) underwent conventional scanning with retrospective ECG-gating. Comparative analysis of CT values of lumen, objective image quality assessment, subjective image quality evaluations, and diagnostic efficacy were performed.Results: CT values, image noise, signal-to-noise ratio (SNR4), and contrast-to-noise ratio (CNR5) were significantly affected by the VMI energy level, and they all increased with decreasing energy levels (P > 0.05). Combining subjective evaluation, the 45 keV VMI was considered the optimum image in group A. The 45 keV VMI exhibited higher CT values of lumen compared to conventional scanning images (P < 0.003 similar to 0.836), but meanwhile, the image noise was also higher in the 45 keV VMI (P = 0.004). Differences between the two groups in SNR, CNR, and diagnostic accuracy were not statistically significant. Compared to group B, the 45 keV VMI showed fewer contrast-induced artifacts (P < 0.001) and higher image quality score (P = 0.037). Group A had a 64 % reduction in radiation dose and a 40 % decrease in iodine dose compared to group B.Conclusion: The combination of dual-energy CT with prospective ECG-gating reduces radiation and iodine doses in pediatric patients with CHD. The 45 keV VMI can provide clinically acceptable image quality while declining contrast agent artifacts."

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