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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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Late post-operative period of truncus arteriosus with a tubular stenosis of theleft pulmonary artery.
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f02: Late post-operative period of truncus arteriosus with a tubular stenosis of theleft pulmonary artery.

Mentions: In the assessment of the pulmonary arteries, the possibility of reconstruction can allowvisualization of the spatial relationship not feasible in two-dimensional procedures andis useful for guiding or planning percutaneous and surgical interventions. Consideringeight patients previously operated on for pulmonary circulation (7 patients withtetralogy of Fallot and 1 patient with truncus arteriosus) and one patient with nativepulmonary artery stenosis, three-dimensional assessment was elucidative with clear anduseful images of the pulmonary branches, subvalvar region, and previously implantedstents (Figure 2). The images were consideredsuperior to 2D-SA acquisitions in patients with an aneurysmatic right ventricularoutflow tract and those with tortuous branches of the pulmonary artery, providingoptimal assessment of these lesions. Finally, stent fractures and neointimal hyperplasiawere better evaluated in two-dimensional angiographies, with little additionalinformation to be obtained from 3D-RA.


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)

Late post-operative period of truncus arteriosus with a tubular stenosis of theleft pulmonary artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f02: Late post-operative period of truncus arteriosus with a tubular stenosis of theleft pulmonary artery.
Mentions: In the assessment of the pulmonary arteries, the possibility of reconstruction can allowvisualization of the spatial relationship not feasible in two-dimensional procedures andis useful for guiding or planning percutaneous and surgical interventions. Consideringeight patients previously operated on for pulmonary circulation (7 patients withtetralogy of Fallot and 1 patient with truncus arteriosus) and one patient with nativepulmonary artery stenosis, three-dimensional assessment was elucidative with clear anduseful images of the pulmonary branches, subvalvar region, and previously implantedstents (Figure 2). The images were consideredsuperior to 2D-SA acquisitions in patients with an aneurysmatic right ventricularoutflow tract and those with tortuous branches of the pulmonary artery, providingoptimal assessment of these lesions. Finally, stent fractures and neointimal hyperplasiawere better evaluated in two-dimensional angiographies, with little additionalinformation to be obtained from 3D-RA.

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