Computed tomography (CT) has a well-established diagnostic role in the assessment of coronary arteries in adults. However, its application in a pediatric setting is still limited and often impaired by several technical issues, such as high heart rates, poor patient cooperation, and radiation dose exposure. Nonetheless, CT is becoming crucial in the noninvasive approach of children affected by coronary abnormalities and congenital heart disease. In some circumstances, CT might be preferred to other noninvasive techniques such as echocardiography and MRI for its lack of acoustic window influence, shorter acquisition time, and high spatial resolution. The introduction of dual-source CT has expanded the role of CT in the evaluation of pediatric cardiovascular anatomy and pathology. Furthermore, technical advances in the optimization of low-dose protocols represent an attractive innovation. Dual-source CT can play a key role in several clinical settings in children, namely in the evaluation of children with suspected congenital coronary artery anomalies, both isolated and in association with congenital heart disease. Moreover, it can be used to assess acquired coronary artery abnormalities, as in children with Kawasaki disease and after surgical manipulation, especially in case of transposition of the great arteries treated with arterial switch operation and in case of coronary re-implantation.

中文翻译：

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儿童双源计算机断层扫描冠状动脉成像。

计算机断层扫描（CT）在成人冠状动脉评估中具有公认的诊断作用。但是，它在儿科环境中的应用仍然受到限制，并且经常会受到一些技术问题的影响，例如高心率，不良的患者合作以及辐射剂量暴露。然而，CT在受冠状动脉异常和先天性心脏病影响的儿童的非侵入性治疗中正变得至关重要。在某些情况下，CT可能比其他无创技术（如超声心动图和MRI）更受青睐，因为它缺乏声窗影响，较短的采集时间和较高的空间分辨率。双源CT的引入扩大了CT在小儿心血管解剖学和病理学评估中的作用。此外，低剂量方案优化方面的技术进步代表了一项有吸引力的创新。双源CT可以在儿童的几种临床情况中发挥关键作用，即在评估可疑的先天性冠状动脉异常的儿童中，无论是孤立的还是与先天性心脏病相关的儿童。此外，它可用于评估获得性冠状动脉异常，例如在川崎病患儿中以及在外科手术后，尤其是在用动脉转换手术治疗的大动脉移位和冠状动脉再植入的情况下。既孤立又与先天性心脏病有关。此外，它可用于评估获得性冠状动脉异常，例如在川崎病患儿中以及在外科手术后，尤其是在用动脉转换手术治疗的大动脉移位和冠状动脉再植入的情况下。既孤立又与先天性心脏病有关。此外，它可用于评估获得性冠状动脉异常，例如在川崎病患儿中以及在外科手术后，尤其是在用动脉转换手术治疗的大动脉移位和冠状动脉再植入的情况下。