Wang Xiangming, Liu Ao, Zhao Yan, Yu Xianbo, Cao Yushuo, Li Min, Liu Jing, Du Yu, Yang Li
Department of Computed Tomography and Magnetic Resonance, Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
School of Mathematics and Science, Hebei GEO University, Shijiazhuang, China.
BMC Cardiovasc Disord. 2025 Jan 24;25(1):48. doi: 10.1186/s12872-025-04499-w.
This study aimed to evaluate the feasibility and accuracy of non-electrocardiogram (ECG)-triggered chest low-dose computed tomography (LDCT) with a kV-independent reconstruction algorithm in assessing coronary artery calcification (CAC) degree and cardiovascular disease risk in patients receiving maintenance hemodialysis (MHD).
In total, 181 patients receiving MHD who needed chest CT and coronary artery calcium score (CACS) scannings sequentially underwent non-ECG-triggered, automated tube voltage selection, high-pitch chest LDCT with a kV-independent reconstruction algorithm and ECG-triggered standard CACS scannings. Then, the image quality, radiation doses, Agatston scores (ASs), and cardiac risk classifications of the two scans were compared.
Of the 181 patients, 89, 83, and 9 were scanned at 100, 110, and 120 kV, respectively. Excluding those scanned at 120 kV, 172 patients were enrolled. Although the ASs of non-ECG-triggered LDCT were lower than those of the standard CACS, the agreement and correlation of ASs of the two scans were excellent, and both intraclass correlation coefficients (ICCs) and Pearson's correlation coefficients were > 0.96. Cardiac risk classifications did not significantly differ between the non-ECG-triggered LDCT and standard CACS (χ = 3.933, P = 0.269), and the agreement was excellent (weighted kappa value = 0.936; 95% confidence interval (CI): 0.903-0.970). The effective radiation doses of standard CACS and non-ECG-triggered chest LDCT scannings were 1.34 ± 0.74 and 1.04 ± 0.35 mSv, respectively.
The non-ECG-triggered, automated tube voltage selection, high-pitch chest LDCT protocol with a kV-independent reconstruction algorithm can obtain chest scans and ASs simultaneously and significantly reduce patients' radiation exposure.
本研究旨在评估采用千伏独立重建算法的非心电图（ECG）触发胸部低剂量计算机断层扫描（LDCT）在评估维持性血液透析（MHD）患者冠状动脉钙化（CAC）程度及心血管疾病风险方面的可行性和准确性。
总共181例需要依次进行胸部CT和冠状动脉钙化积分（CACS）扫描的MHD患者，先后接受了非ECG触发、自动管电压选择、采用千伏独立重建算法的高螺距胸部LDCT以及ECG触发的标准CACS扫描。然后，比较两种扫描的图像质量、辐射剂量、阿加斯顿评分（ASs）和心脏风险分类。
181例患者中，分别有89例、83例和9例在100 kV、110 kV和120 kV下进行扫描。排除在120 kV下扫描的患者后，纳入172例患者。虽然非ECG触发LDCT的ASs低于标准CACS的ASs，但两种扫描的ASs一致性和相关性良好，组内相关系数（ICCs）和皮尔逊相关系数均>0.96。非ECG触发LDCT与标准CACS之间的心脏风险分类无显著差异（χ=3.933，P=0.269），一致性良好（加权kappa值=0.936；95%置信区间（CI）：0.903 - 0.970）。标准CACS和非ECG触发胸部LDCT扫描的有效辐射剂量分别为1.34±0.74和1.04±0.35 mSv。
采用千伏独立重建算法的非ECG触发、自动管电压选择、高螺距胸部LDCT方案能够同时获得胸部扫描图像和ASs，并显著降低患者的辐射暴露。
