ArticlePediatric cardiology2026
Comparative Analysis of Image Quality of Cardiovascular Computed Tomography in Pediatric Congenital Heart Disease in Sedated vs. Non-sedated Patients: A Single-Center Retrospective Study.
Article in Pediatric cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
To evaluate the impact of sedation on image quality in cardiovascular computed tomography (CCT) in congenital heart disease (CHD). CCT plays an important role in CHD assessment. CCT image quality can be compromised by 'patient-based' artifacts, and sedation is thought to minimize these. "Optimal" quality must be carefully considered given the risk of neurodevelopmental delay from cumulative effect of sedation. This was a single-center retrospective study of all consecutive CHD CCT scans performed on pediatric patients (< 12 years). Patients were categorized into three subgroups based on age and four subgroups based on CCT indication. Image analysis was scored by blinded raters using a 4-point Likert scale for image quality, visualization of structure in question, and reporting of elements of diagnosis. Additionally, the raters commented if scan is of diagnostic quality. The study was reported of diagnostic quality if it answered the clinical question. Interobserver analysis was conducted in a subgroup of 100 cases. A total of 291 congenital CCT scans were reviewed, of which 154 met inclusion criteria (age range 0.03-11.6 years; 63% male), including 83 sedated scans. Diagnostic quality was comparable between sedated and non-sedated scans in the overall cohort (94% vs. 99%, p = 0.2), as well as across age and indication subgroups, despite differences in certain image quality parameters. The mean dose length product (DLP) was 25.1 ± 33.6 mGy·cm in the sedated group and 24.8 ± 36.5 mGy·cm in the non-sedated group, with no significant differences across age subgroups (< 2 months: p = 0.2; 2months-4 years: p = 0.6; 4-12 years: p > 0.9). Inter-rater reliability analysis demonstrated good to excellent agreement. Our study demonstrates overall high diagnostic quality of CCT in children with CHD, with no significant difference between sedated and non-sedated groups, despite the presence of artifacts. Radiation dose burden was also comparable between the two groups. Future multicenter studies with larger sample sizes and varied scanner platforms are needed to validate and expand upon these findings.
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