Graef Jessica, Leidel Bernd A, Bressem Keno K, Vahldiek Janis L, Hamm Bernd, Niehues Stefan M
Department of Radiology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, 12203 Berlin, Germany.
Department of Emergency Medicine, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, 12203 Berlin, Germany.
Diagnostics (Basel). 2021 Jun 19;11(6):1122. doi: 10.3390/diagnostics11061122.
Computed tomography (CT) represents the current standard for imaging of patients with acute life-threatening diseases. As some patients present with circulatory arrest, they require cardiopulmonary resuscitation. Automated chest compression devices are used to continue resuscitation during CT examinations, but tend to cause motion artifacts degrading diagnostic evaluation of the chest. The aim was to investigate and evaluate a CT protocol for motion-free imaging of thoracic structures during ongoing mechanical resuscitation. The standard CT trauma protocol and a CT protocol with ECG triggering using a simulated ECG were applied in an experimental setup to examine a compressible thorax phantom during resuscitation with two different compression devices. Twenty-eight phantom examinations were performed, 14 with AutoPulse and 14 with corpuls cpr. With each device, seven CT examinations were carried out with ECG triggering and seven without. Image quality improved significantly applying the ECG-triggered protocol ( < 0.001), which allowed almost artifact-free chest evaluation. With the investigated protocol, radiation exposure was 5.09% higher (15.51 mSv vs. 14.76 mSv), and average reconstruction time of CT scans increased from 45 to 76 s. Image acquisition using the proposed CT protocol prevents thoracic motion artifacts and facilitates diagnosis of acute life-threatening conditions during continuous automated chest compression.
计算机断层扫描 (CT) 是目前对患有急性危及生命疾病的患者进行成像的标准方法。由于一些患者会出现循环骤停,因此需要进行心肺复苏。自动胸外按压设备用于在CT检查期间继续进行复苏,但往往会导致运动伪影,从而降低胸部的诊断评估效果。目的是研究和评估一种在持续机械复苏期间对胸部结构进行无运动成像的CT方案。在实验装置中应用标准CT创伤方案和使用模拟心电图进行心电图触发的CT方案,以使用两种不同的按压设备在复苏过程中检查可压缩的胸部模型。共进行了28次模型检查,使用自动心肺复苏系统(AutoPulse)进行了14次,使用科普尔斯心肺复苏仪(corpuls cpr)进行了14次。对于每种设备,进行了7次有心电图触发的CT检查和7次无心电图触发的CT检查。应用心电图触发方案后图像质量显著提高(<0.001),这使得胸部评估几乎无伪影。采用所研究的方案,辐射暴露增加了5.09%(15.51 mSv对14.76 mSv),CT扫描的平均重建时间从45秒增加到76秒。使用所提出的CT方案进行图像采集可防止胸部运动伪影,并有助于在持续自动胸外按压期间诊断急性危及生命的情况。