Rixe J, Conradi G, Rolf A, Schmermund A, Magedanz A, Erkapic D, Deetjen A, Hamm C W, Dill T
Department of Cardiology, Kerckhoff Heart Centre, Bad Nauheim, Germany.
Heart. 2009 Aug;95(16):1337-42. doi: 10.1136/hrt.2008.161018. Epub 2009 May 28.
Dual-source CT (DSCT) promises a significant reduction of radiation dose exposure for coronary CT angiography (CTA). Large studies on radiation dose estimates are rare.
To compare radiation dose estimates of DSCT with 16- and 64-slice multidetector CT (MDCT) for non-invasive coronary angiography.
Retrospective data analysis was performed on 292 patients: 56 patients were examined with 16-slice MDCT, 38 patients with 64-slice MDCT and 202 patients using DSCT. The effective dose (ED) estimates were calculated for all patients from the dose-length product and the conversion factor k (0.017 mSv/mGy/cm), as recommended by current guidelines.
The mean (SD) ED for patients examined by 16-slice MDCT was 9.8 (1.8) mSv, for 64-slice MDCT 8.6 (2.8) mSv and for DSCT 11.4 (7.2) mSv. With a protocol of 100 kV tube voltage and 110 ms ECG pulsing window the mean (SD) ED was 3.8 (1.7) mSv for DSCT scanning. When DSCT with a tube voltage of 100 kV was used, a significant inverse correlation between heart rate and radiation dose exposure was found.
When standard protocols for coronary CTA with 16-, 64-slice MDCT and DSCT scanners are used, the radiation dose is still high. However, using optimised and individually adjusted protocols low estimated radiation doses can be achieved.
双源CT(DSCT)有望显著降低冠状动脉CT血管造影(CTA)的辐射剂量。关于辐射剂量估计的大型研究很少。
比较双源CT与16层和64层多排螺旋CT(MDCT)用于无创冠状动脉造影时的辐射剂量估计。
对292例患者进行回顾性数据分析:56例患者接受16层MDCT检查,38例患者接受64层MDCT检查,202例患者使用DSCT检查。根据当前指南建议,从剂量长度乘积和转换系数k(0.017 mSv/mGy/cm)计算所有患者的有效剂量(ED)估计值。
16层MDCT检查患者的平均(标准差)ED为9.8(1.8)mSv,64层MDCT为8.6(2.8)mSv,DSCT为11.4(7.2)mSv。采用100 kV管电压和110 ms心电图脉冲窗的方案时,DSCT扫描的平均(标准差)ED为3.8(1.7)mSv。当使用管电压为100 kV的DSCT时,发现心率与辐射剂量暴露之间存在显著的负相关。
当使用16层、64层MDCT和DSCT扫描仪进行冠状动脉CTA的标准方案时,辐射剂量仍然很高。然而,使用优化和个体化调整的方案可以实现较低的估计辐射剂量。