Donnino Robert, Jacobs Jill E, Doshi Jay V, Hecht Elizabeth M, Kim Danny C, Babb James S, Srichai Monvadi B
Department of Medicine, New York University School of Medicine, NYHHA VA Manhattan, 423 First Ave., 12 West Cardiology, New York, NY 10010, USA.
AJR Am J Roentgenol. 2009 Apr;192(4):1051-6. doi: 10.2214/AJR.08.1198.
Dual-source CT improves temporal resolution, and theoretically improves the diagnostic image quality of coronary artery examinations without requiring preexamination beta-blockade. The purpose of our study was to show the improved diagnostic image quality of dual-source CT compared with single-source CT despite the absence of preexamination beta-blockade in the dual-source CT group.
We performed a retrospective analysis of consecutive patients who underwent coronary artery evaluation with either single-source CT or dual-source CT at our institution between February 2005 and October 2006. Examination reports were analyzed for the presence of image artifacts, and image quality was graded on a 3-point scale (no, mild, or severe artifact). Type of artifact (motion, calcium, quantum mottle) was also noted.
Examinations (339 single-source CT and 126 dual-source CT) of 465 patients were analyzed. Artifact was reported in 39.8% of examinations using single-source CT and in 29.4% of examinations using dual-source CT (p < 0.05). The number of examinations with motion artifact was significantly higher with single-source CT than with dual-source CT (15.9% vs 4.8%; p < 0.001) despite significantly higher heart rates in the dual-source CT group (59.4 +/- 8.4 vs 68.6 +/- 14.6 beats per minute; p < 0.001). No patients in the dual-source CT group received preexamination beta-blockade compared with 81% of patients in the single-source CT group. The presence of severe (nondiagnostic) calcium artifact was also significantly reduced in the dual-source CT group (13.0% vs 3.2%; p < 0.001).
Dual-source CT provides significantly better diagnostic image quality than single-source CT despite higher heart rates in the dual-source CT group. These findings support the use of dual-source CT for coronary artery imaging without the need for preexamination beta-blockade.
双源CT提高了时间分辨率,并且理论上在无需检查前使用β受体阻滞剂的情况下可提高冠状动脉检查的诊断图像质量。我们研究的目的是表明,尽管双源CT组未进行检查前β受体阻滞剂预处理,但与单源CT相比,双源CT的诊断图像质量仍有所提高。
我们对2005年2月至2006年10月期间在本机构接受单源CT或双源CT冠状动脉评估的连续患者进行了回顾性分析。分析检查报告中图像伪影的存在情况,并将图像质量按3分制进行分级(无、轻度或重度伪影)。还记录了伪影类型(运动、钙化、量子斑点)。
分析了465例患者的检查(339例单源CT和126例双源CT)。单源CT检查中有39.8%报告有伪影,双源CT检查中有29.4%报告有伪影(p<0.05)。尽管双源CT组心率明显更高(59.4±8.4对68.6±14.6次/分钟;p<0.001),但单源CT检查中出现运动伪影的次数明显高于双源CT(15.9%对4.8%;p<0.001)。双源CT组没有患者接受检查前β受体阻滞剂预处理,而单源CT组有81%的患者接受了预处理。双源CT组中严重(非诊断性)钙化伪影的出现率也显著降低(13.0%对3.2%;p<0.001)。
尽管双源CT组心率较高,但双源CT提供的诊断图像质量明显优于单源CT。这些发现支持在无需检查前β受体阻滞剂预处理的情况下使用双源CT进行冠状动脉成像。