Department of Diagnostic Radiology, University Hospital Freiburg, Freiburg, Germany.
Eur Radiol. 2010 Aug;20(8):1851-5. doi: 10.1007/s00330-010-1744-4. Epub 2010 Mar 4.
To prospectively investigate the feasibility, image quality and radiation dose estimates for computed tomography angiography (CTA) of the pulmonary veins and left atrium using prospective electrocardiography (ECG)-triggered sequential dual-source (DS) data acquisition at end-systole in patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation.
Thirty-five patients (mean age 66.2 +/- 12.6 years) with paroxysmal atrial fibrillation underwent prospective ECG-triggered sequential DS-CTA with tube current (250 mAs/rotation) centred 250 ms past the R-peak. Tube voltage was adjusted to the BMI (<25 kg/m(2): 100 kV, >25 kg/m(2): 120 kV). Presence of motion or stair-step artefacts was assessed. Effective radiation dose was calculated from the dose-length product.
All data sets could be integrated into the electroanatomical mapping system. Twenty-two patients (63%) were in sinus rhythm (mean heart rate 69.2 +/- 11.1 bpm, variability 1.0 +/- 1.7 bpm) and 13 (37%) showed an ECG pattern of atrial fibrillation (mean heart rate 84.8 +/- 16.6 bpm, variability 17.9 +/- 7.5 bpm). Minor step artefacts were observed in three patients (23%) with atrial fibrillation. Mean estimated effective dose was 1.1 +/- 0.3 and 3.0 +/- 0.5 mSv for 100 and 120 kV respectively.
Imaging of pulmonary vein anatomy is feasible using prospective ECG-triggered sequential data acquisition at end-systole regardless of heart rate or rhythm at the benefit of low radiation dose.
前瞻性地研究在阵发性心房颤动患者射频消融术中，使用前瞻性心电图（ECG）触发的舒张末期顺序双源（DS）数据采集技术进行肺静脉和左心房 CT 血管造影（CTA）的可行性、图像质量和辐射剂量估算。
35 例阵发性心房颤动患者（平均年龄 66.2 ± 12.6 岁）接受前瞻性 ECG 触发的舒张末期顺序 DS-CTA 检查，管电流（250 mAs/旋转）在 R 波后 250 ms 处中心化。管电压根据 BMI 进行调整（<25 kg/m2：100 kV，>25 kg/m2：120 kV）。评估运动或阶梯状伪影的存在。有效辐射剂量根据剂量长度乘积计算。
所有数据集都可以整合到电生理图谱系统中。22 例患者（63%）处于窦性心律（平均心率 69.2 ± 11.1 bpm，变异性 1.0 ± 1.7 bpm），13 例（37%）表现为心房颤动的心电图模式（平均心率 84.8 ± 16.6 bpm，变异性 17.9 ± 7.5 bpm）。3 例（23%）心房颤动患者观察到轻微的阶梯状伪影。100 kV 和 120 kV 时，平均估计有效剂量分别为 1.1 ± 0.3 和 3.0 ± 0.5 mSv。
使用前瞻性 ECG 触发的舒张末期顺序数据采集技术，无论心率或节律如何，都可以实现肺静脉解剖结构的成像，具有低辐射剂量的优势。
