University of Groningen, University Medical Center Groningen, Center for Medical Imaging North-East Netherlands (CMI-NEN), Groningen, The Netherlands.
Erasmus MC, Dept. of Public Health, Rotterdam, The Netherlands.
J Cardiovasc Comput Tomogr. 2018 Jul-Aug;12(4):298-304. doi: 10.1016/j.jcct.2018.02.005. Epub 2018 Mar 1.
To determine the impact of high-pitch spiral acquisition on radiation dose and cardiovascular disease (CVD) risk stratification by coronary artery calcium (CAC) assessment with computed tomography in individuals with a high heart rate.
Of the ROBINSCA trial, 1990 participants with regular rhythm and heart rates >65 beats per minute (bpm) were included. As reference, 390 participants with regular heart rates ≤65 bpm were used. All participants underwent prospectively electrocardiographically(ECG)-triggered imaging of the coronary arteries using dual source CT at 120 kVp, 80 ref mAs using both high-pitch spiral mode and sequential mode. Radiation dose, Agatston score, number of positive scores, as well as median absolute difference of the Agatston score were determined and participants were stratified into CVD risk categories.
A similar percentage of participants with low heart rates and high heart rates had a positive CAC score in data sets acquired in high-pitch spiral (low heart rate: 57.7%, high heart rate: 55.8%) and sequential mode (58.0%, 54.7%, p = n.s.). The median absolute difference in Agatston scores between acquisition modes was 14.2% and 9.2%, for the high and low heart rate groups, respectively. Excellent agreement for risk categorization between the two data acquisition modes was found for the high (κ = 0.927) and low (κ = 0.946) heart rate groups. Radiation dose was 48% lower for high-pitch spiral versus sequential acquisitions.
Radiation dose for the quantification of coronary calcium can be reduced by 48% when using the high-pitch spiral acquisition mode compared to the sequential mode in participants with a regular high heart rate. CVD risk stratification agreement between the two modes of data acquisition is excellent.
为了确定在心率较高的个体中，使用高螺旋采集对冠状动脉钙化（CAC）评估的 CT 进行心血管疾病（CVD）风险分层的辐射剂量的影响。
ROBINSCA 试验共纳入 1990 名节律正常且心率＞65 次/分钟（bpm）的患者。作为参考，使用了 390 名节律正常且心率≤65 bpm 的患者。所有患者均使用双源 CT 行前瞻性心电图（ECG）触发的冠状动脉成像，管电压 120 kVp，80 ref mAs，分别采用高螺旋模式和序列模式。确定辐射剂量、Agatston 评分、阳性评分数量以及 Agatston 评分的中位数绝对差，并将患者分层为 CVD 风险类别。
在高螺旋（低心率组：57.7%，高心率组：55.8%）和序列（58.0%，54.7%，p=无统计学意义）模式采集的数据集中，低心率和高心率患者的 CAC 评分阳性率百分比相似。两种采集模式之间的 Agatston 评分中位数绝对差分别为高心率组和低心率组的 14.2%和 9.2%。两种数据采集模式对高（κ=0.927）和低（κ=0.946）心率组的风险分类具有极好的一致性。与序列采集相比，高螺旋采集时的辐射剂量降低了 48%。
与序列采集相比，在节律正常的高心率患者中，使用高螺旋采集模式可将冠状动脉钙化定量的辐射剂量降低 48%。两种数据采集模式之间的 CVD 风险分层一致性极好。
