Apfaltrer Georg, Szolar Dieter H, Wurzinger Eric, Takx Richard A P, Nance John W, Dutschke Anja, Tschauner Sebastian, Loewe Christian, Ringl Helmut, Sorantin Erich, Apfaltrer Paul
Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
Diagnostikum Graz-Südwest, Graz, Austria.
Am J Cardiol. 2017 Apr 15;119(8):1156-1161. doi: 10.1016/j.amjcard.2016.12.028. Epub 2017 Jan 25.
The aim of this study was to assess the image quality (IQ) and radiation dose of third-generation dual-source computed tomography (CT) coronary angiography (cCTA) in comparison with 64-slice single-source CT. This retrospective study included 140 patients (73 men, mean age 62 ± 11 years) with low-to-intermediate probability of coronary artery disease who underwent either third-generation dual-source cCTA using prospectively electrocardiography-triggered high-pitch spiral acquisition (n = 70) (group 1) or retrospective electrocardiography-gated cCTA on a 64-slice CT system (n = 70) (group 2). Contrast-to-noise and signal-to-noise ratios were measured within the aorta and coronary arteries. Subjective IQ was assessed using a 5-point Likert scale. Effective dose was estimated using specific conversion factors. The contrast-to-noise ratio of group 1 was significantly higher than group 2 at all levels (all p <0.001). Signal-to-noise ratio of group 1 was also significantly higher than group 2 (p <0.05), except for the distal left circumflex artery. Subjective IQ for group 1 was rated significantly better than for group 2 (median score [25th to 75th percentile]: 1 [1 to 2] vs 2 [2 to 3]; p <0.001). The median effective dose was 1.55 mSv (1.09 to 1.88) in group 1 versus 12.29 mSv (11.63 to 14.36) in group 2 (p <0.001) which corresponds to a mean radiation dose reduction of 87.4%. In conclusion, implementation of third-generation dual-source CT system for cCTA leads to improved IQ with significant radiation dose savings.
本研究旨在评估第三代双源计算机断层扫描(CT)冠状动脉造影(cCTA)与64层单源CT相比的图像质量(IQ)和辐射剂量。这项回顾性研究纳入了140例冠状动脉疾病可能性为低到中等的患者(73例男性,平均年龄62±11岁),这些患者接受了使用前瞻性心电图触发高螺距螺旋采集的第三代双源cCTA(n = 70)(第1组)或64层CT系统上的回顾性心电图门控cCTA(n = 70)(第2组)。在主动脉和冠状动脉内测量对比噪声比和信噪比。使用5点李克特量表评估主观IQ。使用特定转换因子估计有效剂量。第1组在所有水平的对比噪声比均显著高于第2组(所有p<0.001)。第1组的信噪比也显著高于第2组(p<0.05),左回旋支远端除外。第1组的主观IQ评分显著优于第2组(中位数评分[第25至75百分位数]:1[1至2]对2[2至3];p<0.001)。第1组的有效剂量中位数为1.55 mSv(1.09至1.88),而第2组为12.29 mSv(11.63至14.36)(p<0.001),这相当于平均辐射剂量降低了87.4%。总之, 将第三代双源CT系统用于cCTA可提高图像质量并显著节省辐射剂量。