Hôpital Cardio-vasculaire et Pneumologique Louis Pradel, Bron, France.
Br J Radiol. 2011 Jan;84(997):51-7. doi: 10.1259/bjr/13222537.
Our aim was to compare image quality, coronary segment assessability and radiation dose in prospectively gated axial (PGA) coronary CT angiography (CTA) and conventional retrospectively gated helical (RGH) coronary CTA.
Institutional review committee approval and informed consent were obtained. RGH CTA was performed in 41 consecutive patients (33 males, 8 females; mean age 52.6 years), then the PGA CTA technique was evaluated in 41 additional patients (24 males, 17 females; mean age 57.3 years) all with a pre-scan heart rate of ≤70 beats per minute (bpm). Two radiologists, blinded to clinical information, independently scored subjective image quality on a five-point ordinal scale.
The mean effective dose in the PGA group was 4.7±0.9 mSv, representing a 69% dose reduction compared with the RGH CTA group (15.1±1.9 mSv, p<0.001). The mean segmental image quality score was significantly higher in the PGA group (3.4 vs 3.2) than in the RGH CTA group (p<0.005). The percentage of assessable segments was 98.1% in the PGA group and 97.3% in the RGH group (p = 0.610).
PGA CTA offers a significant reduction in radiation dose compared with RGH CTA, with comparable image quality for patients with heart rates below 70 bpm.
本研究旨在比较前瞻性心电门控轴向（PGA）冠状动脉 CT 血管造影（CTA）与传统回顾性心电门控螺旋（RGH）冠状动脉 CTA 的图像质量、冠状动脉节段可评估性和辐射剂量。
获得机构审查委员会批准和知情同意。对 41 例连续患者（33 例男性，8 例女性；平均年龄 52.6 岁）进行 RGH CTA 检查，然后对另外 41 例具有≤70 次/分钟（bpm）静息心率的患者（24 例男性，17 例女性；平均年龄 57.3 岁）行 PGA CTA 技术评估。两位放射科医生在不知道临床信息的情况下，独立地对 5 分制的主观图像质量进行评分。
PGA 组的平均有效剂量为 4.7±0.9 mSv，与 RGH CTA 组（15.1±1.9 mSv，p<0.001）相比，剂量降低了 69%。PGA 组的平均节段图像质量评分（3.4）明显高于 RGH CTA 组（3.2）（p<0.005）。PGA 组可评估节段百分比为 98.1%，RGH 组为 97.3%（p = 0.610）。
与 RGH CTA 相比，PGA CTA 可显著降低辐射剂量，对于静息心率低于 70 bpm 的患者，其图像质量具有可比性。
