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A comparison of radiation dose between standard and 3D angiography in congenital heart disease.

Manica JL, Borges MS, Medeiros RF, Fischer Ldos S, Broetto G, Rossi Filho RI - Arq. Bras. Cardiol. (2014)

Bottom Line: In patients weighing more than 45Kg (n=7), this difference was attenuated but still significant (1525 µGy.m2 vs.413µGy.m2, p=0.01).No difference was found between one 3D-RA and three 2D-SA (1525µGy.m2 vs.1238 µGy.m2, p = 0.575) in this population.This difference was significantly higher in patients weighing less than 45Kg (n=9) (713µGy.m2 vs.81µGy.m2, P = 0.008), even when comparing one 3D-RA with three 2D-SA (242µGy.m2, respectively, p<0.008). 3D-RA was extremely useful for the assessment of conduits of univentricular hearts, tortuous branches of the pulmonary artery, and aorta relative to 2D-SA acquisitions.

View Article: PubMed Central - PubMed

ABSTRACT

Background: The use of three-dimensional rotational angiography (3D-RA) to assess patients with congenital heart diseases appears to be a promising technique despite the scarce literature available.

Objectives: The objective of this study was to describe our initial experience with 3D-RA and to compare its radiation dose to that of standard two-dimensional angiography (2D-SA).

Methods: Between September 2011 and April 2012, 18 patients underwent simultaneous 3D-RA and 2D-SA during diagnostic cardiac catheterization. Radiation dose was assessed using the dose-area-product (DAP).

Results: The median patient age and weight were 12.5 years and 47.5 Kg, respectively. The median DAP of each 3D-RA acquisition was 1093µGy.m2 and 190µGy.m2 for each 2D-SA acquisition (p<0.01). In patients weighing more than 45Kg (n=7), this difference was attenuated but still significant (1525 µGy.m2 vs.413µGy.m2, p=0.01). No difference was found between one 3D-RA and three 2D-SA (1525µGy.m2 vs.1238 µGy.m2, p = 0.575) in this population. This difference was significantly higher in patients weighing less than 45Kg (n=9) (713µGy.m2 vs.81µGy.m2, P = 0.008), even when comparing one 3D-RA with three 2D-SA (242µGy.m2, respectively, p<0.008). 3D-RA was extremely useful for the assessment of conduits of univentricular hearts, tortuous branches of the pulmonary artery, and aorta relative to 2D-SA acquisitions.

Conclusions: The radiation dose of 3D-RA used in our institution was higher than those previously reported in the literature and this difference was more evident in children. This type of assessment is of paramount importance when starting to perform 3D-RA.

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Bare stent previously implanted in a patient with aortic coarctation with anadequate late result
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f01: Bare stent previously implanted in a patient with aortic coarctation with anadequate late result

Mentions: Three-dimensional rotational angiography is very useful in patients diagnosed withaortic coarctation. A single acquisition can demonstrate the size of the ascendingaorta, features from the aortic arch hardly viewed in two-dimensional studies, and thepresence of aneurysm in patients previously undergoing percutaneous or surgicalprocedures (Figure 1). In one patient, additionalinformation on aortic arch tortuosity was available because of the spatial resolutionprovided by three-dimensional reconstruction. The possibility of evaluating theascending aorta with the same contrast injection is useful in patients at an increasedrisk of progressive dilatation. An additional 2D-SA injection in these patients does notseem to be useful to provide more information from three-dimensional reconstruction.


A comparison of radiation dose between standard and 3D angiography in congenital heart disease.

Manica JL, Borges MS, Medeiros RF, Fischer Ldos S, Broetto G, Rossi Filho RI - Arq. Bras. Cardiol. (2014)

Bare stent previously implanted in a patient with aortic coarctation with anadequate late result
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150664&req=5

f01: Bare stent previously implanted in a patient with aortic coarctation with anadequate late result
Mentions: Three-dimensional rotational angiography is very useful in patients diagnosed withaortic coarctation. A single acquisition can demonstrate the size of the ascendingaorta, features from the aortic arch hardly viewed in two-dimensional studies, and thepresence of aneurysm in patients previously undergoing percutaneous or surgicalprocedures (Figure 1). In one patient, additionalinformation on aortic arch tortuosity was available because of the spatial resolutionprovided by three-dimensional reconstruction. The possibility of evaluating theascending aorta with the same contrast injection is useful in patients at an increasedrisk of progressive dilatation. An additional 2D-SA injection in these patients does notseem to be useful to provide more information from three-dimensional reconstruction.

Bottom Line: In patients weighing more than 45Kg (n=7), this difference was attenuated but still significant (1525 µGy.m2 vs.413µGy.m2, p=0.01).No difference was found between one 3D-RA and three 2D-SA (1525µGy.m2 vs.1238 µGy.m2, p = 0.575) in this population.This difference was significantly higher in patients weighing less than 45Kg (n=9) (713µGy.m2 vs.81µGy.m2, P = 0.008), even when comparing one 3D-RA with three 2D-SA (242µGy.m2, respectively, p<0.008). 3D-RA was extremely useful for the assessment of conduits of univentricular hearts, tortuous branches of the pulmonary artery, and aorta relative to 2D-SA acquisitions.

View Article: PubMed Central - PubMed

ABSTRACT

Background: The use of three-dimensional rotational angiography (3D-RA) to assess patients with congenital heart diseases appears to be a promising technique despite the scarce literature available.

Objectives: The objective of this study was to describe our initial experience with 3D-RA and to compare its radiation dose to that of standard two-dimensional angiography (2D-SA).

Methods: Between September 2011 and April 2012, 18 patients underwent simultaneous 3D-RA and 2D-SA during diagnostic cardiac catheterization. Radiation dose was assessed using the dose-area-product (DAP).

Results: The median patient age and weight were 12.5 years and 47.5 Kg, respectively. The median DAP of each 3D-RA acquisition was 1093µGy.m2 and 190µGy.m2 for each 2D-SA acquisition (p<0.01). In patients weighing more than 45Kg (n=7), this difference was attenuated but still significant (1525 µGy.m2 vs.413µGy.m2, p=0.01). No difference was found between one 3D-RA and three 2D-SA (1525µGy.m2 vs.1238 µGy.m2, p = 0.575) in this population. This difference was significantly higher in patients weighing less than 45Kg (n=9) (713µGy.m2 vs.81µGy.m2, P = 0.008), even when comparing one 3D-RA with three 2D-SA (242µGy.m2, respectively, p<0.008). 3D-RA was extremely useful for the assessment of conduits of univentricular hearts, tortuous branches of the pulmonary artery, and aorta relative to 2D-SA acquisitions.

Conclusions: The radiation dose of 3D-RA used in our institution was higher than those previously reported in the literature and this difference was more evident in children. This type of assessment is of paramount importance when starting to perform 3D-RA.

Show MeSH
Related in: MedlinePlus