%0 Journal Article
%T Low-Dose Prospectively Electrocardiogram-Gated Axial Dual-Source CT Angiography in Patients with Pulsatile Bilateral Bidirectional Glenn Shunt: An Alternative Noninvasive Method for Postoperative Morphological Estimation
%A Xiaopeng Ji
%A Bin Zhao
%A Zhaoping Cheng
%A Biao Si
%A Zhiheng Wang
%A Yanhua Duan
%A Pei Nie
%A Haiou Li
%A Shifeng Yang
%A Hui Jiao
%A Ximing Wang
%J PLOS ONE
%D 2014
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0094425
%X Objective To explore the clinical value of low-dose prospectively electrocardiogram-gated axial dual-source CT angiography (low-dose PGA scanning, CTA) in patients with pulsatile bilateral bidirectional Glenn shunt (bBDG) as an alternative noninvasive method for postoperative morphological estimation. Methods Twenty patients with pulsatile bBDG (mean age 4.2ˇŔ1.6 years) underwent both low-dose PGA scanning and conventional cardiac angiography (CCA) for the morphological changes. The morphological evaluation included the anatomy of superior vena cava (SVC) and pulmonary artery (PA), the anastomotic location, thrombosis, aorto-pulmonary collateral circulation, pulmonary arteriovenous malformations, etc. Objective and subjective image quality was assessed. Bland¨CAltman analysis and linear regression analyses were used to evaluate the correlation on measurements between CTA and CCA. Effective radiation dose of both modalities was calculated. Results The CT attenuation value of bilateral SVC and PA was higher than 300 HU. The average subjective image quality score was 4.05ˇŔ0.69. The morphology of bilateral SVC and PA was displayed completely and intuitively by CTA images. There were 24 SVC above PA and 15 SVC beside PA. Thrombosis was found in 1 patient. Collateral vessels were detected in 13 patients. No pulmonary arteriovenous malformation was found in our study. A strong correlation (R2>0.8, P<0.001) was observed between the measurements on CTA images and on CCA images. Bland¨CAltman analysis demonstrated a systematic overestimation of the measurements by CTA (the mean value of bias>0).The mean effective dose of CTA and CCA was 0.50ˇŔ0.17 mSv and 4.85ˇŔ1.34 mSv respectively. Conclusion CT angiography with a low-dose PGA scanning is an accurate and reliable noninvasive examination in the assessment of morphological changes in patients with pulsatile bBDG.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0094425