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使用低辐射剂量的第三代双源计算机断层扫描同时评估左心室功能和冠状动脉解剖结构。

Simultaneous Assessment of Left Ventricular Function and Coronary Artery Anatomy by Third-generation Dual-source Computed Tomography Using a Low Radiation Dose.

作者信息

Lee Ji Won, Nam Kyung Jin, Kim Jin You, Jeong Yeon Joo, Lee Geewon, Park So Min, Lim Soo Jin, Choo Ki Seok

机构信息

Department of Radiology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea.

Department of Radiology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea.

出版信息

J Cardiovasc Imaging. 2020 Jan;28(1):21-32. doi: 10.4250/jcvi.2019.0066. Epub 2019 Nov 20.

Abstract

BACKGROUND

To assess left ventricular function and coronary artery simultaneously by third-generation dual-source computed tomography (CT) using a low radiation dose.

METHODS

A total of 48 patients (36 men, 12 women; mean age 57.0 ± 9.5 years) who underwent both electrocardiography-gated cardiac CT angiography (CCTA) using 70-90 kVp and echocardiography were included in this retrospective study. The correlation between left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF) measured using CCTA and echocardiography was determined. The quality of coronary artery images was analyzed using a 4-point scale (1, excellent; 4, poor). The effective radiation dose of CCTA was calculated.

RESULTS

Mean heart rate during the CT examination was 59.9 ± 9.9 bpm (range 38-79) and the body mass index of 48 patients was 24.5 ± 2.6 kg/m² (range 17.0-29.4). LVEDV, LVESV, and LVEF measured using CCTA and echocardiography demonstrated a fair to moderate correlation (Pearson correlation coefficient: r = 0.395, p = 0.005 for LVEDV; r = 0.509. p < 0.001 for LVESV; r = 0.551, p < 0.001 for LVEF). Average image quality score of coronary arteries was 1.0 ± 0.1 (range 1-2). A total of 99.0% (783 of 791) of segments had an excellent image quality score, and 1.0% (8 of 791) of segments had a good score. Mean effective radiation dose was 2.2 ± 0.7 mSv.

CONCLUSIONS

Third-generation dual-source CT using a low tube voltage simultaneously provides information regarding LV function and coronary artery disease at a low radiation dose. It can serve as an alternative option for functional assessment, particularly when other imaging modalities are inadequate.

摘要

背景

使用低辐射剂量的第三代双源计算机断层扫描(CT)同时评估左心室功能和冠状动脉。

方法

本回顾性研究纳入了48例患者(36例男性,12例女性;平均年龄57.0±9.5岁),这些患者均接受了使用70 - 90 kVp的心电图门控心脏CT血管造影(CCTA)和超声心动图检查。确定了使用CCTA和超声心动图测量的左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)和左心室射血分数(LVEF)之间的相关性。使用4分制(1分,优秀;4分,差)分析冠状动脉图像质量。计算CCTA的有效辐射剂量。

结果

CT检查期间的平均心率为59.9±9.9次/分钟(范围38 - 79),48例患者的体重指数为24.5±2.6 kg/m²(范围17.0 - 29.4)。使用CCTA和超声心动图测量的LVEDV、LVESV和LVEF显示出中等至良好的相关性(Pearson相关系数:LVEDV,r = 0.395,p = 0.005;LVESV,r = 0.509,p < 0.001;LVEF,r = 0.551,p < 0.001)。冠状动脉的平均图像质量评分为1.0±0.1(范围1 - 2)。总共99.0%(791个节段中的783个)的节段图像质量评分优秀,1.0%(791个节段中的8个)的节段图像质量评分良好。平均有效辐射剂量为2.2±0.7 mSv。

结论

使用低管电压的第三代双源CT在低辐射剂量下同时提供有关左心室功能和冠状动脉疾病的信息。它可以作为功能评估的替代选择,特别是在其他成像方式不足时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3a9/6992922/1827fe8aa89d/jcvi-28-21-g001.jpg

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