Clinical value of prospective ECG-gated high-pitch CT scanning in the diagnosis of pediatric congenital heart disease
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 Flash 3rd,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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