Beitzke D, Berger-Kulemann V, Schöpf V, Unterhumer S, Spitzer E, Feuchtner G M, Gyöngyösi M, Uyanik-Uenal K, Zuckermann A, Loewe C, Wolf F
Department of Biomedical Imaging and Image Guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria,
Eur Radiol. 2015 Aug;25(8):2310-7. doi: 10.1007/s00330-015-3650-2. Epub 2015 Apr 26.
To prospectively evaluate image quality (IQ) and radiation dose of dual-source cardiac computed tomography (CCTA) using different imaging protocols.
CCTA was performed in 150 patients using the retrospective ECG-gated spiral technique (rECG) the prospective ECG-gated technique (pECG), or the prospective ECG-gated technique with systolic imaging and automated tube voltage selection (pECGsys). IQ was rated using a 16-segment coronary artery model. Techniques were compared for overall IQ, IQ of the large and the small coronary artery segments. Effective dose was used for comparison of radiation dose.
Overall IQ and IQ of the large segments showed no differences between the groups. IQ analysis of the small segments showed lowered IQ in pECGsys compared to rECG (p = 0.02), but not to pECG (p = 0.6). Effective dose did not differ significantly between rECG and pECG (p = 0.13), but was significantly lower for pECGsys (p < 0.001 vs. rECG and pECG).
Radiation dose of dual-source CCTA in heart transplant recipients is significantly reduced by using prospective systolic scanning and automated tube voltage selection, while overall IQ and IQ of the large coronary segments are maintained. IQ appears to be lower compared to retrospective techniques with regard to small coronary segments.
• Cardiac computed tomography angiography is useful for cardiac allograft vasculopathy assessment. • Despite elevated heart rate, dose reduction in cardiac computed tomography is possible. • Prospective systolic gating and automated tube voltage selection enable 50 % dose reduction.
前瞻性评估采用不同成像方案的双源心脏计算机断层扫描（CCTA）的图像质量（IQ）和辐射剂量。
对150例患者进行CCTA检查，采用回顾性心电图门控螺旋技术（rECG）、前瞻性心电图门控技术（pECG）或具有收缩期成像和自动管电压选择功能的前瞻性心电图门控技术（pECGsys）。使用16段冠状动脉模型对IQ进行评分。比较各技术在整体IQ、大冠状动脉节段IQ和小冠状动脉节段IQ方面的差异。采用有效剂量比较辐射剂量。
各组之间的整体IQ和大节段IQ无差异。小节段的IQ分析显示，与rECG相比，pECGsys的IQ降低（p = 0.02），但与pECG相比无差异（p = 0.6）。rECG和pECG之间的有效剂量无显著差异（p = 0.13），但pECGsys的有效剂量显著更低（与rECG和pECG相比，p < 0.001）。
对于心脏移植受者，采用前瞻性收缩期扫描和自动管电压选择可显著降低双源CCTA的辐射剂量，同时保持大冠状动脉节段的整体IQ和IQ。与回顾性技术相比，小冠状动脉节段的IQ似乎较低。
• 心脏计算机断层扫描血管造影术对心脏移植血管病变评估有用。• 尽管心率升高，但心脏计算机断层扫描仍可降低剂量。• 前瞻性收缩期门控和自动管电压选择可使剂量降低50%。
