Department of Radiology, People's Hospital, Peking University, Beijing, 100044, China.
Department of Cardiac, People's Hospital, Peking University, Beijing, 100044, China.
J Cardiovasc Comput Tomogr. 2019 Mar-Apr;13(2):113-117. doi: 10.1016/j.jcct.2019.01.005. Epub 2019 Jan 4.
To evaluate the feasibility of coronary computed tomography angiography (CCTA) in patients with free-breathing using 16-cm z-coverage CT with motion correction algorithm.
616 patients underwent CCTA without heart rate control. 325 examinations were performed during breath-holding (group A), and the remaining 291 were performed during free-breathing (group B). The image quality scores were defined as 1 (excellent), 2 (good), 3 (adequate), and 4 (poor). 22 patients in group A and 24 in group B underwent invasive coronary angiography (ICA) after CCTA within two weeks. The image quality score, diagnostic accuracy using ICA as reference, signal-to-noise ratio (SNR), and effective dose (ED) were compared between the two groups.
Mean heart rate during scanning was 70.8 ± 13.8 bpm in group A and 70.7 ± 13.2 bpm in group B (P = .950). No significant differences were observed in SNR and image quality score (1.49 ± 0.62 vs. 1.53 ± 0.67; P = .647) between the breath-holding and free-breathing groups. ED (1.99 ± 0.83 mSv vs. 2.01 ± 0.88 mSv) was not significantly different between the two groups (P = .975). In a segment-based analysis, the sensitivity, specificity and diagnostic accuracy in the detection of coronary stenosis of more than 50% were 82.1%, 96.8% and 92.2%, respectively in the breath-holding group and 82.2%, 96.6% and 92.2%, respectively in the free-breathing group with no significant differences for these parameters between the two groups.
CCTA for patients without heart rate control and during free-breathing using 16-cm z-coverage CT with motion correction algorithm showed no significant difference in image quality and diagnostic performance compared with CCTA during breath-holding.
评估使用带运动校正算法的 16 厘米 z 覆盖 CT 对自由呼吸患者进行冠状动脉 CT 血管造影（CCTA）的可行性。
616 例患者在未进行心率控制的情况下接受 CCTA 检查。其中 325 例在屏气时进行（A 组），其余 291 例在自由呼吸时进行（B 组）。图像质量评分定义为 1（优秀）、2（良好）、3（可接受）和 4（差）。A 组中 22 例和 B 组中 24 例在 CCTA 后两周内行有创冠状动脉造影（ICA）。比较两组间的图像质量评分、以 ICA 为参考的诊断准确性、信噪比（SNR）和有效剂量（ED）。
A 组和 B 组扫描时的平均心率分别为 70.8±13.8 bpm 和 70.7±13.2 bpm（P=0.950）。屏气组和自由呼吸组的 SNR 和图像质量评分无显著差异（1.49±0.62 vs. 1.53±0.67；P=0.647）。ED（1.99±0.83 mSv 比 2.01±0.88 mSv）在两组间无显著差异（P=0.975）。在节段性分析中，屏气组和自由呼吸组检测到大于 50%的冠状动脉狭窄的敏感性、特异性和诊断准确性分别为 82.1%、96.8%和 92.2%，82.2%、96.6%和 92.2%，两组间各参数无显著差异。
对于未进行心率控制且使用带运动校正算法的 16 厘米 z 覆盖 CT 进行自由呼吸的患者，CCTA 检查在图像质量和诊断性能方面与屏气 CCTA 检查相比无显著差异。
