New 70 kV Protocol Ensures Low Radiation Dose in Patients with Congenital Heart Disease
SOMATOM Definition AS+ scanning
Author: Michael Lell, MD, PD*; Oliver Rompel, MD*´; Andreas Blaha** * Departement or Radiology, University of Erlangen-Nuremberg, Erlangen, Germany; ** Computed Tomography, Siemens Healthcare, Forchheim, Germany
A 10-month-old male baby underwent surgery for multiple ventricular septal defects (VSD) as well as a secundumtype atrial septal defect (ASD). Partially anomalous pulmonary venous return, insufficiency of the tricuspid valve and a patent ductus arteriosus were corrected in prior surgical procedures, as was banding of the pulmonary artery. The post-operative phase, after closure of the VSDs and ASD, was complicated with infection and secretion from the sternotomy wound appeared. Before re-thoracotomy, a low-dose chest CT was performed as planning base for the following surgery.
Diagnosis The scan on a SOMATOM Definition AS+ revealed the proper location of the ductus arteriosus clip. A sickle shaped retrosternal fluid collection could be demonstrated as well as interstitial edema and dystelectasis. The right ventricle is enlarged and the right ventricular wall significantly thickened.
Comments With the fast acquisition time of 1.2 seconds covering 129 mm, precise diagnosis could be established in mild sedation. Children with CHD usually require multiple imaging studies in the Follow-Up. Therefore, it is critical to keep the cumulative radiation dose as low as possible. A dedicated low-dose pediatric acquisition protocol, with auto selection and adjustment of kV and mAs is very useful in this patient group to ensure consistently high image quality at reasonably low dose.
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