Pediatric Cardiology and Cardiac Surgery
Vol.24 No.1 2008 (44-52)

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Masahiro Tahara,1) Chiaki Waki,1) Hiroaki Komatsu,1) Tomohiro Hayashi,1) and Tomoyasu Sato2)

Departments of 1)Pediatrics and 2)Radiology, Tsuchiya General Hospital, Hiroshima, Japan


Background: Heart rate is one of the most important factors for optimal visualization of cardiac CT. We investigated the relation between heart rate and visibility of the coronary arteries with 64-detector row multislice spiral computed tomography (MSCT).
Patients and Methods: Three simulated coronary artery stenosis models (3, 4, and 5 mm) were attached to a moving heart phantom and scanned using 64-detector row MSCT. The heart rate of the phantom was varied between 60 and 150 beats per minutes (bpm). The visibility of simulated coronary arteries was assessed in comparison between cardiac half reconstruction (CHR) and multi-sector reconstruction (MSR). Then contrast-enhanced 64-detector row MSCT was performed in 16 patients under 3 years of age with congenital heart disease and Kawasaki disease without heart rate control. The visibility of coronary artery segments was graded on a three-point scale.
Results: The simulated coronary artery patency was detected in the moving phantom at maximum heart rate (150 bpm) with MSR. Minimum lumen diameter was 0.75 mm. ECG-gated cardiac CT was performed in 9 patients, and non-ECG-gated cardiac CT was performed in 7 patients. The origin and proximal course of coronary arteries in all 9 patients with ECG-gated acquisition were visually evaluated.
Conclusions: 64-detector row MSCT with ECG-gated acquisition is able to visualize the origin and proximal course of coronary arteries in infants under 3 years of age.