Cardiac Imaging Unit, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008 Pamplona, Spain.
Eur Radiol. 2011 Sep;21(9):1887-94. doi: 10.1007/s00330-011-2126-2. Epub 2011 Apr 12.
To assess feasibility, image quality, and radiation dose of prospectively ECG-triggered coronary CT angiography (CTA) in orthotopic heart transplant (OHT) recipients.
47 consecutive OHT recipients (40 men, mean age 62.1 ± 10.9 years, mean heart rate 86.3 ± 14.4 bpm) underwent dual-source CTA to rule out coronary allograft vasculopathy in a prospectively ECG-triggered mode with data acquisition during 35% to 45% of the cardiac cycle. Two independent observers blindly assessed image quality on a per-segment and per-vessel basis using a four-point scale (1-excellent, 4-not evaluable). Scores 1-3 were considered acceptable for diagnosis. Multivariate analysis was performed to evaluate differences between image quality scores obtained at different reconstruction intervals. Effective radiation doses were calculated.
671 coronary segments were evaluated. Interobserver agreement on the image quality was κ=0.75. Diagnostic image quality was observed in 93.9%, 95.5% and 93.3% of the segments at 35%, 40% and 45% reconstruction intervals. Mean image quality score was 1.5 ± 0.7 for the entire coronary tree, 1.4 ± 0.7 for the RCA, 1.6 ± 0.8 for the LCA and 1.6 ± 0.7 for the Cx at the best reconstruction interval. Estimated mean radiation dose was 4.5 ± 1.2 mSv.
Systolic prospectively ECG-triggered CTA allows diagnostic image quality coronary angiograms in OHT recipients at low radiation doses.
评估在原位心脏移植（OHT）受者中前瞻性心电图触发冠状动脉 CT 血管造影（CTA）的可行性、图像质量和辐射剂量。
47 例连续 OHT 受者（40 名男性，平均年龄 62.1 ± 10.9 岁，平均心率 86.3 ± 14.4 bpm）进行双源 CTA，以在前瞻性心电图触发模式下排除冠状动脉移植物血管病，采集数据的时间段为心脏周期的 35%至 45%。两名独立观察者盲法对每段和每支血管的图像质量进行评估，使用四分制（1-优秀，4-不可评估）。评分 1-3 被认为可用于诊断。进行多变量分析以评估在不同重建间隔获得的图像质量评分之间的差异。计算有效辐射剂量。
评估了 671 个冠状动脉节段。观察者间的图像质量一致性为 κ=0.75。在 35%、40%和 45%重建间隔处，93.9%、95.5%和 93.3%的节段获得诊断性图像质量。整个冠状动脉树的平均图像质量评分为 1.5 ± 0.7，RCA 为 1.4 ± 0.7，LCA 为 1.6 ± 0.8，最佳重建间隔的 CX 为 1.6 ± 0.7。估计平均辐射剂量为 4.5 ± 1.2 mSv。
在低辐射剂量下，前瞻性心电图触发 CTA 可在 OHT 受者中获得诊断性冠状动脉血管造影图像。
