Korean Journal of Radiology

  • 제13권6호
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  • Pages.684-693
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  • 2012
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

Prospectively Electrocardiogram-Gated High-Pitch Spiral Acquisition Mode Dual-Source CT Coronary Angiography in Patients with High Heart Rates: Comparison with Retrospective Electrocardiogram-Gated Spiral Acquisition Mode

  • Sun, Kai (Department of Radiology, Baotou Central Hospital) ;
  • Han, Rui-Juan (Department of Cardiology, Baotou Central Hospital) ;
  • Ma, Li-Jun (Department of Radiology, Baotou Central Hospital) ;
  • Wang, Li-Jun (Department of Radiology, Baotou Central Hospital) ;
  • Li, Li-Gang (CT BM Clinic Marketing, Siemens Healthcare) ;
  • Chen, Jiu-Hong (CT BM Clinic Marketing, Siemens Healthcare)
  • 발행 : 2012.12.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To assess the image quality and effective radiation dose of prospectively electrocardiogram (ECG)-gated high-pitch spiral acquisition mode (flash mode) of dual-source CT (DSCT) coronary angiography (CTCA) in patients with high heart rates (HRs) as compared with retrospectively ECG-gated spiral acquisition mode. Materials and Methods: Two hundred and sixty-eight consecutive patients (132 female, mean age: 55 ${\pm}$ 11 years) with mean HR > 65 beats per minute (bpm) were prospectively included in this study. The patients were divided into two groups. Collection was performed in group A CTCA using flash mode setting at 20-30% of the R-R interval, and retrospectively ECG-gated spiral acquisition mode in group B. The image noise, contrast-to-noise ratio (CNR), image quality scores, effective radiation dose and influencing factors on image quality between the two groups were assessed. Results: There were no significant differences in image quality scores and proportions of non-diagnostic coronary artery segments between two groups (image quality scores: 1.064 ${\pm}$ 0.306 [group A] vs. 1.084 ${\pm}$ 0.327 [group B], p = 0.063; proportion of non-diagnostic coronary artery segments: segment-based analysis 1.52% (group A) vs. 1.74% (group B), p = 0.345; patient-based analysis 7.5% (group A) vs. 6.7% (group B), p = 0.812). The estimated radiation dose was 1.0 ${\pm}$ 0.16 mSv in group A and 7.1 ${\pm}$ 1.05 mSv in group B (p = 0.001). Conclusion: In conclusion, in patients with HRs > 65 bpm without cardiac arrhythmia, the prospectively high-pitch spiral-acquisition mode with image-acquired timing set at 20-30% of the R-R interval provides a similar image quality and low rate of non-diagnostic coronary segments to the retrospectively ECG-gated low-pitch spiral acquisition mode, with significant reduction of radiation exposure.

키워드

참고문헌

  1. Husmann L, Herzog BA, Burger IA, Buechel RR, Pazhenkottil AP, von Schulthess P, et al. Usefulness of additional coronary calcium scoring in low-dose CT coronary angiography with prospective ECG-triggering impact on total effective radiation dose and diagnostic accuracy. Acad Radiol 2010;17:201-206 https://doi.org/10.1016/j.acra.2009.09.007
  2. Ropers D, Pohle FK, Kuettner A, Pflederer T, Anders K, Daniel WG, et al. Diagnostic accuracy of noninvasive coronary angiography in patients after bypass surgery using 64-slice spiral computed tomography with 330-ms gantry rotation. Circulation 2006;114:2334-2341; quiz 2334 https://doi.org/10.1161/CIRCULATIONAHA.106.631051
  3. Carrascosa P, Capunay C, Deviggiano A, Goldsmit A, Tajer C, Bettinotti M, et al. Accuracy of low-dose prospectively gated axial coronary CT angiography for the assessment of coronary artery stenosis in patients with stable heart rate. J Cardiovasc Comput Tomogr 2010;4:197-205 https://doi.org/10.1016/j.jcct.2010.04.001
  4. Xu Y, Tang L, Zhu X, Xu H, Tang J, Yang Z, et al. Comparison of dual-source CT coronary angiography and conventional coronary angiography for detecting coronary artery disease. Int J Cardiovasc Imaging 2010;26 Suppl 1:75-81 https://doi.org/10.1007/s10554-009-9568-5
  5. Zhang LJ, Wu SY, Wang J, Lu Y, Zhang ZL, Jiang SS, et al. Diagnostic accuracy of dual-source CT coronary angiography: the effect of average heart rate, heart rate variability, and calcium score in a clinical perspective. Acta Radiol 2010;51:727-740 https://doi.org/10.3109/02841851.2010.492792
  6. Moon JH, Park EA, Lee W, Yin YH, Chung JW, Park JH, et al. The diagnostic accuracy, image quality and radiation dose of 64-slice dual-source CT in daily practice: a single institution's experience. Korean J Radiol 2011;12:308-318 https://doi.org/10.3348/kjr.2011.12.3.308
  7. Hausleiter J, Meyer T, Hermann F, Hadamitzky M, Krebs M, Gerber TC, et al. Estimated radiation dose associated with cardiac CT angiography. JAMA 2009;301:500-507 https://doi.org/10.1001/jama.2009.54
  8. Scheffel H, Alkadhi H, Leschka S, Plass A, Desbiolles L, Guber I, et al. Low-dose CT coronary angiography in the step-andshoot mode: diagnostic performance. Heart 2008;94:1132-1137 https://doi.org/10.1136/hrt.2008.149971
  9. Achenbach S, Goroll T, Seltmann M, Pflederer T, Anders K, Ropers D, et al. Detection of coronary artery stenoses by low-dose, prospectively ECG-triggered, high-pitch spiral coronary CT angiography. JACC Cardiovasc Imaging 2011;4:328-337 https://doi.org/10.1016/j.jcmg.2011.01.012
  10. Alkadhi H, Stolzmann P, Desbiolles L, Baumueller S, Goetti R, Plass A, et al. Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart 2010;96:933-938 https://doi.org/10.1136/hrt.2009.189100
  11. Leschka S, Stolzmann P, Desbiolles L, Baumueller S, Goetti R, Schertler T, et al. Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience. Eur Radiol 2009;19:2896-2903 https://doi.org/10.1007/s00330-009-1618-9
  12. Wang YN, Li L, Kong LY, Wang ZW, Zhou K, Cao J, et al. [Coronary computed tomographic angiography using low-dose prospectively electrocardiographic triggered high-pitch spiral acquisition by dual-source computed tomography: image quality and radiation dose]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2010;32:597-600
  13. Seifarth H, Wienbeck S, Pusken M, Juergens KU, Maintz D, Vahlhaus C, et al. Optimal systolic and diastolic reconstruction windows for coronary CT angiography using dual-source CT. AJR Am J Roentgenol 2007;189:1317-1323 https://doi.org/10.2214/AJR.07.2711
  14. Weustink AC, Mollet NR, Pugliese F, Meijboom WB, Nieman K, Heijenbrok-Kal MH, et al. Optimal electrocardiographic pulsing windows and heart rate: effect on image quality and radiation exposure at dual-source coronary CT angiography. Radiology 2008;248:792-798 https://doi.org/10.1148/radiol.2483072098
  15. Araoz PA, Kirsch J, Primak AN, Braun NN, Saba O, Williamson EE, et al. Optimal image reconstruction phase at low and high heart rates in dual-source CT coronary angiography. Int J Cardiovasc Imaging 2009;25:837-845 https://doi.org/10.1007/s10554-009-9489-3
  16. Goetti R, Feuchtner G, Stolzmann P, Desbiolles L, Fischer MA, Karlo C, et al. High-pitch dual-source CT coronary angiography: systolic data acquisition at high heart rates. Eur Radiol 2010;20:2565-2571 https://doi.org/10.1007/s00330-010-1838-z
  17. Halliburton SS, Sola S, Kuzmiak SA, Obuchowski NA, Desai M, Flamm SD, et al. Effect of dual-source cardiac computed tomography on patient radiation dose in a clinical setting: comparison to single-source imaging. J Cardiovasc Comput Tomogr 2008;2:392-400 https://doi.org/10.1016/j.jcct.2008.09.003
  18. Lell M, Marwan M, Schepis T, Pflederer T, Anders K, Flohr T, et al. Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience. Eur Radiol 2009;19:2576-2583 https://doi.org/10.1007/s00330-009-1558-4
  19. Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 1975;51:5-40 https://doi.org/10.1161/01.CIR.51.4.5
  20. Qi W, Li J, Du X. Method for automatic tube current selection for obtaining a consistent image quality and dose optimization in a cardiac multidetector CT. Korean J Radiol 2009;10:568-574 https://doi.org/10.3348/kjr.2009.10.6.568
  21. Publication no. EUR 16262 EN. In: Menzel HG, Schibilla H, Teunen D, eds. European guidelines on quality criteria for computed tomography. Luxembourg: European Commission;2000
  22. Wolf F, Leschka S, Loewe C, Homolka P, Plank C, Schernthaner R, et al. Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom: comparison with the sequential and low-pitch spiral mode. Eur Radiol 2010;20:2084-2091 https://doi.org/10.1007/s00330-010-1792-9
  23. Goo HW. State-of-the-art CT imaging techniques for congenital heart disease. Korean J Radiol 2010;11:4-18 https://doi.org/10.3348/kjr.2010.11.1.4
  24. Duarte R, Fernandez G, Castellon D, Costa JC. Prospective Coronary CT Angiography 128-MDCT Versus Retrospective 64-MDCT: Improved Image Quality and Reduced Radiation Dose. Heart Lung Circ 2011;20:119-125 https://doi.org/10.1016/j.hlc.2010.09.005
  25. Hirai N, Horiguchi J, Fujioka C, Kiguchi M, Yamamoto H, Matsuura N, et al. Prospective versus retrospective ECG-gated 64-detector coronary CT angiography: assessment of image quality, stenosis, and radiation dose. Radiology 2008;248:424-430 https://doi.org/10.1148/radiol.2482071804
  26. Earls JP, Berman EL, Urban BA, Curry CA, Lane JL, Jennings RS, et al. Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique: improved image quality and reduced radiation dose. Radiology 2008;246:742-753 https://doi.org/10.1148/radiol.2463070989
  27. Raff GL, Gallagher MJ, O'Neill WW, Goldstein JA. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 2005;46:552-557 https://doi.org/10.1016/j.jacc.2005.05.056
  28. Rixe J, Rolf A, Conradi G, Elsaesser A, Moellmann H, Nef HM, et al. Image quality on dual-source computed-tomographic coronary angiography. Eur Radiol 2008;18:1857-1862 https://doi.org/10.1007/s00330-008-0947-4
  29. Stolzmann P, Leschka S, Scheffel H, Krauss T, Desbiolles L, Plass A, et al. Dual-source CT in step-and-shoot mode: noninvasive coronary angiography with low radiation dose. Radiology 2008;249:71-80 https://doi.org/10.1148/radiol.2483072032
  30. Scheffel H, Alkadhi H, Plass A, Vachenauer R, Desbiolles L, Gaemperli O, et al. Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control. Eur Radiol 2006;16:2739-2747 https://doi.org/10.1007/s00330-006-0474-0
  31. Achenbach S, Ropers D, Holle J, Muschiol G, Daniel WG, Moshage W. In-plane coronary arterial motion velocity: measurement with electron-beam CT. Radiology 2000;216:457-463 https://doi.org/10.1148/radiology.216.2.r00au19457
  32. Adler G, Meille L, Rohnean A, Sigal-Cinqualbre A, Capderou A, Paul JF. Robustness of end-systolic reconstructions in coronary dual-source CT angiography for high heart rate patients. Eur Radiol 2010;20:1118-1123 https://doi.org/10.1007/s00330-009-1642-9
  33. Guyer S. Cardiovascular physiology as a basis for clinical and financial outcomes. J Cardiovasc Manag 1998;9:20-24
  34. Tsakiris S, Zarros A. Medical physiology and experimentation: reconsidering the undergraduate examination structure. Adv Physiol Educ 2006;30:94-95 https://doi.org/10.1152/advan.00078.2005
  35. Alonso Guerrero A. [Cardiac physiology]. Rev Enferm 1983;6:49-54
  36. Saffitz JE. Dependence of electrical coupling on mechanical coupling in cardiac myocytes: insights gained from cardiomyopathies caused by defects in cell-cell connections. Ann N Y Acad Sci 2005;1047:336-344 https://doi.org/10.1196/annals.1341.030
  37. Leschka S, Wildermuth S, Boehm T, Desbiolles L, Husmann L, Plass A, et al. Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality. Radiology 2006;241:378-385 https://doi.org/10.1148/radiol.2412051384
  38. Weustink AC, Neefjes LA, Kyrzopoulos S, van Straten M, Neoh Eu R, Meijboom WB, et al. Impact of heart rate frequency and variability on radiation exposure, image quality, and diagnostic performance in dual-source spiral CT coronary angiography. Radiology 2009;253:672-680 https://doi.org/10.1148/radiol.2533090358
  39. Herzog BA, Husmann L, Burkhard N, Gaemperli O, Valenta I, Tatsugami F, et al. Accuracy of low-dose computed tomography coronary angiography using prospective electrocardiogram-triggering: first clinical experience. Eur Heart J 2008;29:3037-3042 https://doi.org/10.1093/eurheartj/ehn485
  40. Maruyama T, Takada M, Hasuike T, Yoshikawa A, Namimatsu E, Yoshizumi T. Radiation dose reduction and coronary assessability of prospective electrocardiogram-gated computed tomography coronary angiography: comparison with retrospective electrocardiogram-gated helical scan. J Am Coll Cardiol 2008;52:1450-1455 https://doi.org/10.1016/j.jacc.2008.07.048
  41. Husmann L, Valenta I, Gaemperli O, Adda O, Treyer V, Wyss CA, et al. Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. Eur Heart J 2008;29:191-197
  42. Alkadhi H, Stolzmann P, Scheffel H, Desbiolles L, Baumuller S, Plass A, et al. Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters. Eur J Radiol 2008;68:385-391 https://doi.org/10.1016/j.ejrad.2008.08.015
  43. Achenbach S, Marwan M, Ropers D, Schepis T, Pflederer T, Anders K, et al. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J 2010;31:340-346 https://doi.org/10.1093/eurheartj/ehp470

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