Wolak Arik, Gutstein Ariel, Cheng Victor Y, Suzuki Yasuyuki, Thomson Louise E, Friedman John, Dey Damini, Hayes Sean W, Slomka Piotr J, Germano Guido, Berman Daniel S
Departments of Imaging and Medicine, and CSMC Burns & Allen Research Institute, Cedars-Sinai Medical Center, University of California at Los Angeles, CA, USA.
J Cardiovasc Comput Tomogr. 2008 May-Jun;2(3):172-80. doi: 10.1016/j.jcct.2008.03.003. Epub 2008 Mar 22.
Patients with atrial fibrillation (AF) are generally excluded from coronary CT angiography (CCTA) studies because of motion artifact resulting from irregular rhythm. The 83-millisecond temporal resolution of the dual-source CT (DSCT) may be sufficient to allow CCTA in patients with AF.
We examined the feasibility of DSCT in patients with AF referred for CCTA.
We compared results of CCTA with DSCT in 24 consecutive patients with AF with 119 control patients in sinus rhythm. Standard relative-delay phase reconstruction (40%-80% of cardiac cycle) was used, with additional absolute delay reconstruction performed when indicated. Image quality was scored both subjectively and objectively.
Patients with AF were older (68.5 +/- 14.0 years versus 62.5 +/- 12.1 years; P = 0.03). Maximum heart rate during injection was 102.5 +/- 30.4 beats/min and 70.8 +/- 16.6 beats/min in the AF and control groups, respectively (P < 0.01). Mean (+/-SD) Agatston score was 321 +/- 366 (range, 0-1158) and 361 +/- 743 (range, 0-3948) in the AF and control groups, respectively (P = 0.8). No difference was observed in the proportion of uninterpretable segments between the 2 groups, 7 (2%) in the AF group and 12 (1%) in the control group (P = NS). Two (8%) of 24 studies in the AF group and 12 (10%) of 119 studies in the control group were nondiagnostic (P = NS). Image quality was good or excellent in 13 (54%) of 21 AF cases compared with 94 (79%) of 119 control cases (P = 0.01). Absolute delay reconstruction was needed in 9 (38%) of 24 AF cases.
These preliminary data show that interpretable CCTA data can be obtained in patients with AF using DSCT. The need for absolute delay reconstruction is common.
由于心律不齐导致的运动伪影，心房颤动（AF）患者通常被排除在冠状动脉CT血管造影（CCTA）研究之外。双源CT（DSCT）83毫秒的时间分辨率可能足以对AF患者进行CCTA检查。
我们研究了对因CCTA前来就诊的AF患者进行DSCT检查的可行性。
我们将24例连续的AF患者的CCTA结果与119例窦性心律的对照患者进行了比较。采用标准的相对延迟期重建（心动周期的40%-80%），必要时进行额外的绝对延迟重建。对图像质量进行主观和客观评分。
AF患者年龄更大（68.5±14.0岁对62.5±12.1岁；P = 0.03）。注射期间的最大心率在AF组和对照组分别为102.5±30.4次/分钟和70.8±16.6次/分钟（P < 0.01）。AF组和对照组的平均（±标准差）阿加斯顿积分分别为321±366（范围0-1158）和361±743（范围0-3948）（P = 0.8）。两组间不可解释节段的比例无差异，AF组7个（2%），对照组12个（1%）（P =无显著性差异）。AF组24例研究中有2例（8%）、对照组119例研究中有12例（10%）诊断不明确（P =无显著性差异）。21例AF病例中有13例（54%）图像质量良好或优秀，而119例对照病例中有94例（79%）（P = 0.01）。24例AF病例中有9例（38%）需要进行绝对延迟重建。
这些初步数据表明，使用DSCT可以在AF患者中获得可解释的CCTA数据。绝对延迟重建的需求很常见。
