Schertler Thomas, Glücker Thomas, Wildermuth Simon, Jungius Karl-Peter, Marincek Borut, Boehm Thomas
Department of Medical Radiology, Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland.
Emerg Radiol. 2005 Dec;12(1-2):19-29. doi: 10.1007/s10140-005-0435-y. Epub 2005 Nov 9.
This study aims to assess the influence of ECG-gated acquisition on workflow and to compare image quality and diagnostic certainty for retrospectively ECG-gated and nongated multidetector computed tomography of the chest in the emergency suite.
Thirty-two consecutive patients were referred for both an ECG-gated and a nongated CT to rule out traumatic thoracic injury (n=15) or acute aortic dissection (n=17). The time from the start of the transportation from the emergency suite to the CT room until the start of the CT scan was recorded. Using a scoring system, the image quality of axial images and multiplanar reformats, the presence of disease, and the subjective diagnostic certainty were assessed with regard to the vascular structures, the bone structures, and the lung parenchyma.
The time needed for transportation and patient preparation was 12.1+/-1.7 min (8.1-14.5 min). The motion artifacts of the thoracic aorta and the supra-aortic vessels were significantly reduced in the ECG-gated data acquisition compared with the nongated technique (P<0.001). Subjective diagnostic certainty for assessment of the aorta was significantly better using ECG gating. The image quality of the lung parenchyma (P<0.005), the spine (P<0.005), and the ribs (P<0.002) was inferior in the ECG-gated data sets but did not compromise the detection rate of traumatic lesions and fractures.
Performing ECG gating in the emergency room did not slow down the diagnostic workup. ECG-gated acquisition performed better in the assessment of the aorta, but image quality for lung and bone structures was slightly reduced. Further studies are required to assess the influence of the imaging technique on the diagnostic outcome.
本研究旨在评估心电图门控采集对工作流程的影响，并比较急诊室中回顾性心电图门控和非门控胸部多排螺旋计算机断层扫描的图像质量和诊断确定性。
连续32例患者接受了心电图门控和非门控CT检查，以排除创伤性胸部损伤（n = 15）或急性主动脉夹层（n = 17）。记录从急诊室开始转运至CT室到开始CT扫描的时间。使用评分系统，针对血管结构、骨骼结构和肺实质，评估轴位图像和多平面重建的图像质量、疾病的存在情况以及主观诊断确定性。
转运和患者准备所需时间为12.1±1.7分钟（8.1 - 14.5分钟）。与非门控技术相比，心电图门控数据采集中胸主动脉和主动脉弓上血管的运动伪影显著减少（P < 0.001）。使用心电图门控评估主动脉时，主观诊断确定性明显更好。心电图门控数据集中肺实质（P < 0.005）、脊柱（P < 0.005）和肋骨（P < 0.002）的图像质量较差，但不影响创伤性病变和骨折的检出率。
在急诊室进行心电图门控不会减慢诊断检查的速度。心电图门控采集在主动脉评估中表现更好，但肺和骨骼结构的图像质量略有降低。需要进一步研究来评估成像技术对诊断结果的影响。
