Coronary stent evaluation with coronary computed tomographic angiography: Comparison between low-osmolar, high-iodine concentration iomeprol-400 and iso-osmolar, lower-iodine concentration iodixanol-320
Coronary stent evaluation with coronary computed tomographic angiography: Comparison between low-osmolar, high-iodine concentration iomeprol-400 and iso-osmolar, lower-iodine concentration iodixanol-320
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DOI：
10.1016/j.jcct.2013.12.003
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发表时间：
2014-01-01
影响因子：
5.4
通讯作者：
Pepi, Mauro
中科院分区：
文献类型：
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作者：
Andreini, Daniele;Pontone, Gianluca;Pepi, Mauro
背景：多排螺旋CT冠状动脉造影(MDCT-CA)评价支架的可靠性仍存在争议，造影剂特性是否会影响MDCT-CA的诊断性能尚不清楚。目的：比较碘丙醇-400和碘黄醇-320在冠状动脉支架置入术中的应用价值。方法：采用MDCT-CA对254例冠状动脉支架置入术患者进行随诊，随机分为三组，分别为碘丙醇-400(n=83)、碘-320(n=87)、碘-320(n=87)和碘-320(n=84)。记录扫描前和扫描结束时的心率、心率变异、心率早搏和扫描时视觉模拟评分的热感。测量主动脉根部和冠状动脉的平均密度。对图像质量评分和伪影类型进行评估。结果：组3的平均衰减显著低于其他组。第3组支架可评估性显著高于第2组(99%比91%和4%比15%)和第1组(99%比92%和4%比17%)，主要原因是射束硬化伪影的发生率显著降低(第3组分别为3例比第2组22例和27例)。在第3组中，视觉模拟评分、成像结束时的心率以及在扫描过程中出现早搏的患者数量显著低于其他组。结论：碘-320提供了比碘-400更好的冠状动脉支架图像质量，允许更高的MDCT-CA可评价性。(C)2014年心血管计算机断层扫描学会。版权所有。
Background: Reliability of coronary angiography by multidetector row CT (MDCT-CA) for stent evaluation is still a matter for debate, and it is unknown whether contrast medium characteristics may affect diagnostic performance of MDCT-CA. Objective: We compared iomeprol-400 with iodixanol-320 to evaluate coronary stents with MDCT-CA.Methods: We randomly assigned 254 patients undergoing coronary stent follow-up-with the use of MDCT-CA to iomeprol-400 at 5.0 mL/sec flow rate (group 1; n = 83), iodixanol-320 at 6.2 mL/sec flow rate (group 2; n = 87), and iodixanol-320 at 5.0 mL/sec flow rate (group 3; n = 84). Heart rate (HR) immediately before and at the end of scanning, HR variation, premature heart beats, and heat sensation by visual analog scale during scanning were recorded. Mean attenuation was measured in the aortic root and coronary arteries. Image quality score and type of artifacts were assessed.Results: Mean attenuation was significantly lower in group 3 than in the other groups. In group 3, stent evaluability was significantly higher and artifact rate was significantly lower than in group 2 (99% vs 91% and 4% vs 15%) and group 1 (99% vs 92% and 4% vs 17%), respectively, mainly because of a significant lower rate of beam-hardening artifacts (3 cases in group 3 vs 22 and 27 in groups 2 and 3, respectively). In group 3, visual analog scale, HR at the end of imaging, and number of patients with premature heart beats during the scan were significantly lower than in the other groups.Conclusions: Iodixanol-320 provides better image quality of coronary stents, allowing higher MDCT-CA evaluability, than iomeprol-400. (C) 2014 Society of Cardiovascular Computed Tomography. All rights reserved.