Department of Radiology, The Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Changsha, 410013, China.
United Imaging Healthcare Co., Ltd., Shanghai, 201807, China.
Eur Radiol. 2023 Oct;33(10):7034-7043. doi: 10.1007/s00330-023-09528-w. Epub 2023 Mar 11.
To investigate the potential diagnostic value of one-stop combined CT angiography (CTA) as the first examination for patients suspected of coronary artery disease (CAD) or craniocervical artery disease (CCAD), and compare its clinical performance with two consecutive CTA scans.
Patients with suspected but unconfirmed CAD or CCAD were prospectively enrolled and grouped randomly to undergo coronary and craniocervical CTA using the combined protocol (group 1) or the consecutive protocol (group 2). Diagnostic findings were evaluated for both the targeted and non-targeted regions. The objective image quality, overall scan time, radiation dose, and contrast medium dosage were compared between the two groups.
Each group enrolled 65 patients. A substantial number of lesions were found in non-targeted regions, which was 44/65 (67.7%) by patients for group 1 and 41/65 (63.1%) for group 2, reiterating the necessity of extending the scan coverage. Specifically, lesions in non-targeted regions were detected more often for patients suspected of CCAD than for those suspected of CAD (71.4% vs 61.7%). With 21.5% (51.1 s) reduction of scan time and 21.8% (20.8 mL) less contrast medium as compared to the consecutive protocol, high-quality images were obtained by the combined protocol.
One-stop combined CTA enables effective detection of lesions in non-targeted regions at a lower cost of scan time and contrast medium than two separate examinations and is thus worth taking as the first examination for patients suspected of CAD or CCAD.
• Extending the scan range for coronary or craniocervical CTA has the potential to reveal lesions in non-targeted regions. • One-stop combined CTA as enabled on high-speed wide-detector CT delivers high-quality images at a lower cost of contrast medium and operational time than two consecutive CTA scans. • Patients with suspected but unconfirmed CAD or CCAD may benefit from the one-stop combined CTA in the first examination.
探讨一站式联合 CT 血管造影（CTA）作为疑似冠心病（CAD）或颅颈血管疾病（CCAD）患者的首选检查方法的潜在诊断价值，并与两次连续 CTA 扫描进行比较。
前瞻性纳入疑似但未经证实的 CAD 或 CCAD 患者，随机分组，采用联合方案（组 1）或连续方案（组 2）行冠状动脉和颅颈 CTA。评估目标区域和非目标区域的诊断发现。比较两组之间的目标图像质量、总扫描时间、辐射剂量和对比剂用量。
每组纳入 65 例患者。非目标区域发现大量病变，组 1 为 44/65（67.7%），组 2 为 41/65（63.1%），再次强调扩大扫描范围的必要性。具体来说，疑似 CCAD 的患者比疑似 CAD 的患者更容易在非目标区域发现病变（71.4%比 61.7%）。与连续方案相比，联合方案的扫描时间减少 21.5%（51.1 秒），对比剂用量减少 21.8%（20.8 毫升），可获得高质量的图像。
一站式联合 CTA 能够以较低的扫描时间和对比剂成本有效检测非目标区域的病变，比两次单独检查更具成本效益，因此值得作为疑似 CAD 或 CCAD 患者的首选检查。
扩展冠状动脉或颅颈 CTA 的扫描范围有可能发现非目标区域的病变。
高速宽探测器 CT 上的一站式联合 CTA 可提供高质量的图像，与两次连续 CTA 扫描相比，可降低对比剂和操作时间成本。
疑似但未经证实的 CAD 或 CCAD 患者可能受益于一站式联合 CTA 进行首次检查。
