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Dual-source computed tomography coronary artery imaging in children

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Abstract

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.

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Authors and Affiliations

  1. Advanced Cardiovascular Imaging Unit – Department of Imaging, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

    Aurelio Secinaro, Davide Curione, Teresa Pia Santangelo, Paolo Ciancarella & Carmela Napolitano

  2. Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, UK

    Kristian Havmand Mortensen

  3. Pediatric Cardiology and Cardiac Surgery Department, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

    Alessia Del Pasqua & Paolo Ciliberti

  4. UCL Centre for Cardiovascular Imaging, Institute of Cardiovascular Science, University College of London, Great Ormond Street Hospital for Children, London, UK

    Andrew Mayall Taylor

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  1. Aurelio Secinaro
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  2. Davide Curione
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  3. Kristian Havmand Mortensen
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Secinaro, A., Curione, D., Mortensen, K.H. et al. Dual-source computed tomography coronary artery imaging in children. Pediatr Radiol 49, 1823–1839 (2019). https://doi.org/10.1007/s00247-019-04494-2

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