Finck Tom, Klambauer Konstantin, Hendrich Eva, Will Albrecht, Martinoff Stefan, Hadamitzky Martin
Institute of Radiology and Nuclear Medicine, German Heart Centre Munich, Lazarettstr. 36, 80636 Munich, Germany.
J Cardiovasc Dev Dis. 2021 Sep 24;8(10):119. doi: 10.3390/jcdd8100119.
To investigate a high-pitch spiral first (HPSF) approach for coronary computed tomography angiography (CCTA) in an unselected patient cohort and compare diagnostic yield and radiation exposure to CCTAs acquired via conventional, non-high-pitch spiral first (NHPSF) scan regimes. All consecutive patients from 1 January 2015 to 31 December 2017 were included. Two investigation protocols (HPSF/NHPSF) were used with the aim to achieve diagnostic image quality of all coronary segments. Low-pitch secondary scans followed the initial examination if image quality was unsatisfactory. Dosage and image quality were compared between both regimes. 1410 patients were subject to a HPSF and 236 patients to a NHPSF approach. While the HPSF approach led to a higher fraction of re-scans (35% vs. 11%, < 0.001), the fraction of aggregate scans that remained non-diagnostic after considering the initial and secondary scan was comparably low for the HPSF and NHPSF approach (0.78 vs. 0%, = 0.18). Aggregate radiation exposure in the HPSF protocol was significantly lower (1.12 mSv (IQR: 0.73, 2.10) vs. 3.96 mSv (IQR: 2.23, 8.33) < 0.001). In spite of a higher number of re-scans, a HPSF approach leads to a reduction in overall radiation exposure with diagnostic yields similar to a NHPSF approach.
在未经筛选的患者队列中研究用于冠状动脉计算机断层扫描血管造影（CCTA）的高螺距螺旋优先（HPSF）方法，并将其诊断率和辐射暴露与通过传统的非高螺距螺旋优先（NHPSF）扫描方案获得的CCTA进行比较。纳入了2015年1月1日至2017年12月31日期间的所有连续患者。使用了两种研究方案（HPSF/NHPSF），目的是获得所有冠状动脉节段的诊断图像质量。如果图像质量不令人满意，则在初次检查后进行低螺距二次扫描。比较了两种方案之间的剂量和图像质量。1410例患者接受了HPSF方法，236例患者接受了NHPSF方法。虽然HPSF方法导致重新扫描的比例更高（35%对11%，<0.001），但在考虑初次和二次扫描后仍无法诊断的总扫描比例对于HPSF和NHPSF方法而言相对较低（0.78对0%，P=0.18）。HPSF方案中的总辐射暴露显著更低（1.12 mSv（四分位间距：0.73，2.10）对3.96 mSv（四分位间距：2.23，8.33），<0.001）。尽管重新扫描的次数更多，但HPSF方法导致总体辐射暴露减少，诊断率与NHPSF方法相似。
