Klinikum Frankfurt (Oder), Interventional Cardiology, Germany, Frankfurt/O, Germany; Institute for Cardiovascular Translational Research of the Atlantic, ICTRA, Berlin, Germany.
Cardiol J. 2018;25(5):574-581. doi: 10.5603/CJ.a2018.0112. Epub 2018 Sep 24.
Non-occlusive technique is universally accepted for acquisition of coronary optical coherence tomography (OCT), but the amount of contrast infused is still inconsistently calculated. Proposed herein, is an empirical formula for accurate contrast volume calculation.
In an observational prospective study, contrast volume of consecutive patients undergoing OCT was either calculated with formula, or eyeballed based on manufacturer recommendations. The quality of pullback, defined as % of high quality cross-sections (CS) in the segment of interest (SOI), was analyzed by two independent operators and compared between groups, together with the amount of contrast per pullback.
Sixty patients (115 pullbacks, 4252 CS) were imaged using the formula, vs. 18 patients (22 pullbacks, 777 CS) eyeballing the contrast volume. The formula group used 18 mm/s as pullback speed more often (82.6% vs. 40.9%, p = 0.0001), but there were no significant differences between groups in SOI length or vessel imaged. The formula resulted in higher pullback quality than eyeballing (96.55% vs. 63.55%, p < 0.0001), interobserver agreement Kappa 0.903 (p < 0.0001), and tended to use less contrast per pullback than the eyeball group (13.03 mL vs. 14.55 mL, p = 0.057). After adjusting for pullback speed, SOI length and vessel in multivariate linear regression, the use of the formula significantly reduced the amount of contrast in 4.50 mL on average.
Optical coherence tomography acquisition with the non-occlusive technique can be substantially eased with the use of a novel formula to calculate the contrast volume required. This method optimises the quality of the images whilst reducing the amount of contrast per pullback.
非闭塞技术已被普遍接受用于获取冠状动脉光相干断层扫描（OCT），但注入的对比剂量仍不一致。本文提出了一种准确计算对比剂体积的经验公式。
在一项观察性前瞻性研究中，连续接受 OCT 检查的患者的对比剂体积是通过公式计算的，或者根据制造商的建议目测。两名独立操作人员分析了回撤质量，定义为感兴趣节段（SOI）中高质量横断面（CS）的百分比，并比较了两组之间的差异，同时比较了每次回撤的对比剂用量。
60 例患者（115 次回撤，4252 个 CS）采用公式计算，18 例患者（22 次回撤，777 个 CS）目测对比剂体积。公式组更常使用 18mm/s 的回撤速度（82.6% vs. 40.9%，p=0.0001），但两组 SOI 长度或成像血管无显著差异。与目测相比，公式法可获得更高的回撤质量（96.55% vs. 63.55%，p<0.0001），观察者间一致性 Kappa 值为 0.903（p<0.0001），且每次回撤的对比剂用量也少于目测组（13.03mL vs. 14.55mL，p=0.057）。在校正了回撤速度、SOI 长度和血管后，多变量线性回归显示，公式法平均可减少 4.50mL 的对比剂用量。
使用非闭塞技术获取光学相干断层扫描时，使用新公式计算所需的对比剂体积可以大大简化操作。这种方法优化了图像质量，同时减少了每次回撤的对比剂用量。
