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Cardiac computed tomography and conventional angiography in the diagnosis of congenital cardiac disease in children: recent trends and radiation doses

Published online by Cambridge University Press:  10 May 2011

Guy G. Gherardi ,
Gareth R. Iball ,
Michael J. Darby  and
John D.R. Thomson
Guy G. Gherardi*
Affiliation:
School of Medicine, Leeds Institute of Medical Education, University of Leeds, Leeds, United Kingdom
Gareth R. Iball
Affiliation:
Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
Michael J. Darby
Affiliation:
Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
John D.R. Thomson
Affiliation:
Department of Paediatric Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
*
Correspondence to: G.G. Gherardi, School of Medicine, University of Leeds, 7.09 Worsley Building, Leeds LS2 9JT, United Kingdom. Tel: 07763907615; Fax: 01133434375; E-mail: guygherardi@gmail.com
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Abstract

Background

The use of imaging that employs ionising radiation is increasing in the setting of paediatric cardiology. Children's high radiosensitivity and the lack of contemporary radiation data warrant a review of the radiation doses from the latest “state-of-the-art” angiography and computed tomography systems.

Objectives

In children aged less than 16 years with congenital cardiac disease, we aimed to report: recent trends in the use of diagnostic angiography and cardiac dual-source computed tomography; the characteristics, lesions, and imaging histories of patients undergoing these procedures; and the average radiation doses imparted by each modality.

Study design

Retrospective review of consecutive cases undergoing cardiac computed tomography or diagnostic angiography in a teaching hospital between January, 2008 and December, 2009. Radiation doses were converted to effective doses (millisievert) using published conversion factors.

Results

Angiography was performed 3.7 times more often than computed tomography. Computed tomography examinations increased by 92.5%, whereas angiography decreased by 26.4% in 2009 compared with 2008. Patients undergoing computed tomography were younger and weighed less than those undergoing angiography, but lesions were similar between the 2 groups. Multiple lifetime angiography was more prevalent than multiple lifetime computed tomography (p < 0.001). The median procedural dose – range – from angiography and computed tomography was 5 (0.2–27.8) and 1.7 (0.5–9.5) millisieverts, respectively (p < 0.001).

Conclusion

Despite not being completely analogous investigations, computed tomography should be considered prior to angiography and not withheld on radiation dose concerns, given that it imparts lower and more consistent doses than conventional angiography.

Keywords

Paediatric cardiologyimagingdual-source computed tomography
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 6 , 28 October 2011 , pp. 616 - 622
Copyright
Copyright © Cambridge University Press 2011

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