Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No.2, Anzhen Road, Chaoyang District, 100029 Beijing, China.
Eur Radiol. 2013 Jul;23(7):1822-8. doi: 10.1007/s00330-013-2793-2. Epub 2013 May 4.
To investigate the feasibility of applying prospectively ECG-triggered sequential coronary CT angiography (CCTA) to patients with atrial fibrillation (AF) and evaluate the image quality and radiation dose compared with a retrospectively ECG-gated helical protocol.
100 patients with persistent AF were enrolled. Fifty patients were randomly assigned to a prospective protocol and the other patients to a retrospective protocol using a second-generation dual-source CT (DS-CT). Image quality was evaluated using a four-point grading scale (1 = excellent, 2 = good, 3 = moderate, 4 = poor) by two reviewers on a per-segment basis. The coronary artery segments were considered non-diagnostic with a quality score of 4. The radiation dose was evaluated.
Diagnostic segment rate in the prospective group was 99.4 % (642/646 segments), while that in the retrospective group was 96.5 % (604/626 segments) (P < 0.001). Effective dose was 4.29 ± 1.86 and 11.95 ± 5.34 mSv for each of the two protocols (P < 0.001), which was a 64 % reduction in the radiation dose for prospective sequential imaging compared with retrospective helical imaging.
In AF patients, prospectively ECG-triggered sequential CCTA is feasible using second-generation DS-CT and can decrease >60 % radiation exposure compared with retrospectively ECG-gated helical imaging while improving diagnostic image quality.
• Coronary computed tomographic angiography (CCTA) can be difficult in patients with arrhythmias. • Prospectively ECG-triggered sequential CCTA is feasible in patients with atrial fibrillation. • Prospective sequential imaging can improve quality compared with retrospective analysis. • Prospective sequential imaging decreases radiation exposure by 64 % compared with retrospective mode.
旨在探讨前瞻性心电图触发的序贯冠状动脉 CT 血管造影（CCTA）在心房颤动（AF）患者中的应用可行性，并与回顾性心电图门控螺旋扫描方案进行比较，评估其图像质量和辐射剂量。
连续纳入 100 例持续性 AF 患者，其中 50 例患者随机分配至前瞻性组，50 例患者分配至回顾性组，采用第二代双源 CT（DS-CT）进行检查。由 2 名观察者以节段为单位，采用 4 分制对图像质量进行评估（1 分=优，2 分=良，3 分=可，4 分=差）。评分 4 分表示节段不可诊断。评估冠状动脉节段的辐射剂量。
前瞻性组的诊断节段率为 99.4%（642/646 节段），而回顾性组为 96.5%（604/626 节段）（P<0.001）。两个方案的有效剂量分别为 4.29±1.86 和 11.95±5.34 mSv（P<0.001），与回顾性螺旋扫描相比，前瞻性序贯成像的辐射剂量降低了 64%。
在 AF 患者中，第二代 DS-CT 行前瞻性心电图触发的序贯 CCTA 是可行的，与回顾性 ECG 门控螺旋扫描相比，可降低超过 60%的辐射暴露，同时提高诊断图像质量。
• 心律失常患者行冠状动脉 CT 血管造影（CCTA）检查较为困难。• 前瞻性心电图触发的序贯 CCTA 在心房颤动患者中是可行的。• 前瞻性序贯成像可提高图像质量，优于回顾性分析。• 与回顾性模式相比，前瞻性序贯成像可降低 64%的辐射暴露。
