Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography: Comparison with Retrospective Spiral Technique
Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography: Comparison with Retrospective Spiral Technique
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DOI：
10.1016/j.acra.2012.01.009
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发表时间：
2012-05-01
影响因子：
4.8
通讯作者：
Jacobs, Jill E.
中科院分区：
文献类型：
--
作者：
Srichai, Monvadi B.;Lim, Ruth P.;Jacobs, Jill E.
原理和目的：心脏CT血管成像算法强调减少辐射，同时保持诊断图像质量(IQ)。这项研究的目的是在包括超重和肥胖者在内的患者群体中使用前瞻性心电触发的高音调心脏CT血管成像(Flash-CT)和回溯性心电门控(Retro-CT)来评估智商和读数的变异性。材料和方法：70名患者(24名女性，平均年龄60岁)在性别、年龄、体重指数(27.4+/-5.5 kg/m(2))和钙质评分(184 328)匹配的情况下接受心脏CT血管成像，35人使用Flash-CT(定义Flash)，35人使用回顾CT(Somtom定义)。图像重建使用标准方案和最小运动时相，用于回顾CT采集。两位独立的盲人读者使用18节段模型对冠状动脉进行了评估，对智商进行了5分、Likert类型的评分，对冠状动脉狭窄进行了5分的半定量和二进制评分。结果：与传统CT相比，Flash-CT的有效辐射剂量(1.50 mSv比17.3 mSv，P<；0.0001)和平均心率(58比62次/min，P<；0.05)显著降低。评估了740个节段(>；1.5 mm)。在每节段总的10个节段上，闪光CT扫描和回顾CT扫描之间的差异无统计学意义(3.11+/-0.75vs3.10+/-0.82，P=0.94)。与回顾CT相比，Flash-CT的智商并不低(95%可信区间为-0.25~0.26)。对于所有冠状动脉节段，Flash-CT和回顾CT在诊断中的可变性没有显著差异(77.5%比78.2%，P=.83)。结论：Flash-CT是一种可以接受的冠状动脉CT血管成像方法，可以在不影响智商的情况下减少辐射剂量，适用于超重和肥胖者。
Rationale and Objectives: Cardiac computed tomographic angiography algorithms emphasize radiation reduction while maintaining diagnostic image quality (IQ). The aim of this study was to evaluate IQ and interreader variability using prospective electrocardiographically triggered high-pitch spiral cardiac computed tomographic angiography (FLASH-CT) compared to retrospective electrocardiographic gating (RETRO-CT) for coronary artery disease evaluation in a patient population including overweight and obese individuals.Materials and Methods: Seventy patients (24 women; mean age, 60 years) matched for gender, age, body mass index (27.4 +/- 5.5 kg/m(2)), and calcium score (184 328) underwent cardiac computed tomographic angiography, 35 with FLASH-CT (Definition Flash) and 35 with RETRO-CT (Somatom Definition). Images were reconstructed using standard protocols and least motion phase for RETRO-CT acquisitions. Two independent, blinded readers evaluated the coronary arteries using an 18-segment model, grading IQ on a 5-point, Likert-type scale and coronary stenosis on a 5-point semiquantitative and binary scale.Results: Effective radiation dose (1.50 vs 17.3 mSv, P < .0001) and mean heart rate (58 vs 62 beats/min, P < .05) were significantly lower for FLASH-CT compared to RETRO-CT. Seven hundred forty segments (>1.5 mm) were evaluated. There was no significant difference between FLASH-CT and RETRO-CT scans in overall per-segment 10(3.11 +/- 0.75 vs 3.10 +/- 0.82, P = .94). FLASH-CT had noninferior IQ relative to RETRO-CT (95% confidence interval, -0.25 to 0.26). There was no significant difference in interreader variability in diagnosis between FLASH-CT and RETRO-CT for all coronary segments (77.5% vs 78.2%, P = .83).Conclusions: FLASH-CT is an acceptable coronary computed tomographic angiographic method for reducing radiation dose without compromising IQ for a patient population including overweight and obese individuals.