Halliburton Sandra S, Sola Srikanth, Kuzmiak Stacie A, Obuchowski Nancy A, Desai Milind, Flamm Scott D, Schoenhagen Paul
Cardiovascular Imaging Laboratory, Imaging Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
J Cardiovasc Comput Tomogr. 2008 Nov;2(6):392-400. doi: 10.1016/j.jcct.2008.09.003. Epub 2008 Oct 9.
Dual-source computed tomography (DSCT) was introduced with significant hardware and software changes compared with single-source CT (SSCT), resulting in improved temporal resolution (83 ms) and the potential for improved image quality. The effect of these changes on radiation dose requirements for coronary CT angiography in clinical practice has not been investigated.
We evaluated patient radiation dose and image quality of electrocardiogram (ECG)-gated helical techniques, using DSCT compared with SSCT for clinical imaging of the coronary arteries.
DSCT data from 160 patients were evaluated; 82 patients (DSCT group 1) were imaged with early software, and 78 patients (DSCT group 2) were imaged with a later software version. Patients imaged with SSCT (n = 124) were the control group. Effective radiation dose values were estimated for all patients. Image noise was measured, and image quality was evaluated on a 5-point scale.
Effective dose values for DSCT group 2 (11.7 +/- 4.0 mSv) were not different from those for SSCT group (10.9 +/- 2.9 mSv); the highest doses, 13.2 +/- 3.2 mSv, were recorded for DSCT group 1 (P < 0.001). A decrease in image noise was observed for DSCT compared with SSCT (P <or= 0.001) as was an increase in image quality (P < 0.01). With optimized DSCT imaging, lower dose values were associated with (1) shorter scan range, (2) lower maximum tube current, and (3) lower fraction of R-R interval receiving maximum tube current.
ECG-gated helical DSCT can provide images of the coronary arteries with improved image quality and decreased noise without an increase in radiation dose compared with SSCT in clinical patient groups.
与单源CT(SSCT)相比,双源计算机断层扫描(DSCT)在硬件和软件方面有重大改变,从而提高了时间分辨率(83毫秒)并有可能改善图像质量。这些改变对临床实践中冠状动脉CT血管造影辐射剂量要求的影响尚未得到研究。
我们评估了使用DSCT与SSCT进行冠状动脉临床成像时,心电图(ECG)门控螺旋技术的患者辐射剂量和图像质量。
评估了160例患者的DSCT数据;82例患者(DSCT第1组)使用早期软件成像,78例患者(DSCT第2组)使用更新的软件版本成像。使用SSCT成像的患者(n = 124)作为对照组。估算了所有患者的有效辐射剂量值。测量图像噪声,并采用5分制评估图像质量。
DSCT第2组的有效剂量值(11.7±4.0 mSv)与SSCT组(10.9±2.9 mSv)无差异;DSCT第1组记录到最高剂量,为13.2±3.2 mSv(P < 0.001)。与SSCT相比,DSCT的图像噪声降低(P≤0.001),图像质量提高(P < 0.01)。通过优化DSCT成像,较低剂量值与以下因素相关:(1)扫描范围较短,(2)最大管电流较低,以及(3)接受最大管电流的R-R间期比例较低。
与临床患者组中的SSCT相比,ECG门控螺旋DSCT能够提供图像质量更高、噪声更低的冠状动脉图像,且辐射剂量不增加。