Preoperative Assessment of the Aortic Arch by High-Pitch Dual-Source Computed Tomography in Neonates and Babies with Congenital Heart Disease: A Single-Center, Retrospective Analysis of 37 Cases

Objectives: Evaluation of feasibility, impact and image quality of high pitch DSCT, and 3D reconstructions to assess the arbitrary anatomical malformations of the aortic arch in neonates and babies.

Methods: During a 3-year period between 2011 and 2013, in a total of 37 consecutive patients with CHD, mean age 0.02 years (range 0; 0.95), imaging was performed to assess the aortic arch anatomy using a DSCT scanner (SOMATOM Definition Flash, Siemens) with the following low dose scan parameters: 0.28 seconds gantry rotation time; 411 mm/s table speed (pitch: 3.0); real-time anatomy-based tube current modulation (CAREDose4D) at 80 KV. Image reconstruction in 0.6 mm slices, 3D reconstruction with TeraRecon software. In all patients, contrast agent was manually injected without delay (iopamidol, 2 mL/kg body weight, 300 mg/mL). The accuracy and impact of the 3D reconstructions was compared with the intraoperative findings using a 5-point scale.

Results: In all 37 cases, imaging was successful without complications. 3D imaging of the aortic anatomy, the quality was rated as very useful or even essential in all cases. Mean dose-length product was 6.5 ± 2.59 mGy cm, CTDIvol 0.38 ± 0.11, effective dose 0.53 ± 0.21 mSv.

Conclusion: Low dose DSCT is an ultrafast and appropriate imaging modality in the preoperative assessment of the aortic arch in CHD. 3D imaging enables an advanced surgical planning without the need of an experienced imaginativeness.