Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, South Korea.
Int J Cardiovasc Imaging. 2010 Feb;26 Suppl 1:93-101. doi: 10.1007/s10554-009-9554-y. Epub 2009 Dec 23.
We sought to determine the cut-off point of the average heart rate (HR) and HR differences in obtaining diagnostic image quality using prospective electrocardiographically-triggered (PT) coronary computed tomographic angiography (CCTA) and to compare image quality and radiation dose for CCTA obtained with PT CCTA and retrospective electrocardiographically-gated (RG) CCTA. A total of 178 patients who were referred for CCTA were enrolled in the study. Two independent radiologists evaluated subjective image quality. The non-diagnostic coronary segments were 32 of 1,226 segments (2.6%) for PT CCTA and 12 of 1,346 segments (0.9%) for RG CCTA (P < 0.001). The mean image quality scores for PT CCTA and RG CCTA were 3.82 +/- 0.29 and 3.93 +/- 0.14, respectively. The mean radiation dose of patients that underwent PT CCTA was 3.83 +/- 0.84 mSv and RG CCTA 10.7 +/- 2.70 mSv. For patients who underwent PT CCTA, image quality was inversely related to HR (56.5 +/- 4.3 bpm; r = 0.38; P < 0.001) and HR differences (2.8 +/- 2.7 bpm; r = 0.49; P < 0.001). With the use of receiver operator characteristic analysis, a cut-off HR of 57 bpm (58% sensitivity, 67% specificity) and HR difference of 6 bpm (93% sensitivity, 46% specificity) were the best threshold for the prediction of diagnostic image quality. In patients with a regular, low HR, PT CCTA offers diagnostic image quality and substantially reduces effective radiation compared with the use of RG CCTA with dose modulation.
我们旨在确定使用前瞻性心电图触发（PT）冠状动脉计算机断层扫描血管造影（CCTA）获得诊断图像质量的平均心率（HR）和 HR 差异的截止点，并比较使用 PT CCTA 和回顾性心电图门控（RG）CCTA 获得的 CCTA 的图像质量和辐射剂量。这项研究共纳入了 178 名接受 CCTA 检查的患者。两名独立的放射科医生评估了主观图像质量。PT CCTA 中 32 个（2.6%）非诊断性冠状动脉节段和 RG CCTA 中 12 个（0.9%）（P < 0.001）非诊断性冠状动脉节段。PT CCTA 和 RG CCTA 的平均图像质量评分分别为 3.82 ± 0.29 和 3.93 ± 0.14。接受 PT CCTA 的患者的平均辐射剂量为 3.83 ± 0.84 mSv，而 RG CCTA 为 10.7 ± 2.70 mSv。对于接受 PT CCTA 的患者，图像质量与 HR（56.5 ± 4.3 bpm；r = 0.38；P < 0.001）和 HR 差异（2.8 ± 2.7 bpm；r = 0.49；P < 0.001）呈负相关。使用接受者操作特征分析，57 bpm（58%的敏感性，67%的特异性）的 HR 截止值和 6 bpm（93%的敏感性，46%的特异性）的 HR 差异是预测诊断图像质量的最佳阈值。在 HR 规则且较低的患者中，与使用剂量调制的 RG CCTA 相比，PT CCTA 可提供诊断图像质量并显著降低有效辐射剂量。
