Dual-step prospective ECG-triggered 128-slice dual-source CT for evaluation of coronary arteries and cardiac function without heart rate control: a technical note
Dual-step prospective ECG-triggered 128-slice dual-source CT for evaluation of coronary arteries and cardiac function without heart rate control: a technical note
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DOI：
10.1007/s00330-010-1794-7
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发表时间：
2010-09-01
影响因子：
5.9
通讯作者：
Leschka, Sebastian
中科院分区：
文献类型：
--
作者：
Feuchtner, Gudrun;Goetti, Robert;Leschka, Sebastian
描述前瞻性ECG触发双源CT双阶脉冲采用自适应序贯管电流调制技术对51例心血管手术前后的连续患者进行了检查，（pECG（双步））128层双源CT无心率控制（主填充窗口：40%RR间期> 65 bpm/70%RR间期< 65 bpm）。对冠状动脉图像质量进行评分（4分制），评价心功能，平均心率为68次/分。37例患者处于稳定窦性心律（SR）; 14例患者出现心律失常。804/816（98%）节段的冠状动脉图像质量为诊断性。心律失常患者的非诊断性节段数量高于SR患者（4% vs. 0.5%; p = 0.01），图像质量优良的节段较少（79% vs. 94%; p < 0.001），图像质量受损的节段较多（p < 0.001和p = 0.002）。41例（80%）和47例（92%）患者可评价整体和局部LV功能，48例（94%）患者可评价瓣膜功能。在11/14例心律失常患者中，第二步切换到全mAs，将辐射暴露增加到8.6 mAs（p < 0.001）。SR患者的平均辐射剂量为3.8 mSv（范围，1.7-7.9）。pECG（双步）128层DSCT在低辐射剂量下可用于评价稳定窦性心律患者的冠状动脉和心功能，无需心率控制。
To describe prospective ECG-triggered dual-source CT dual-step pulsing (pECG(dual_step)) for evaluation of coronary arteries and cardiac function.Fifty-one consecutive patients pre- or post-cardiovascular surgery were examined with adaptive sequential tube current modulated (pECG(dual-step)) 128-slice dual-source CT without heart rate control (main padding window: 40% RR interval > 65 bpm/70% RR interval < 65 bpm). Image quality of coronary arteries was graded (4-point scale), and cardiac function was evaluated.Mean HR was 68 bpm. Thirty-seven patients were in stable sinus rhythm (SR); 14 had arrhythmia. Image quality of coronary arteries was diagnostic in 804/816 (98%) of segments. The number of non-diagnostic segments was higher in patients with arrhythmia as compared to those in SR (4% vs. 0.5%; p = 0.01), and there were fewer segments with excellent image quality (79% vs. 94%; p < 0.001) and more segments with impaired image quality (p < 0.001 and p = 0.002). Global and regional LV function could be evaluated in 41 (80%) and 47 (92%) patients, and valvular function in 48 (94%). In 11/14 of patients with arrhythmia, the second step switched to full mAs, increasing radiation exposure to 8.6 mAs (p < 0.001). The average radiation dose was 3.8 mSv (range, 1.7-7.9) in patients in SR.pECG(dual-step)128-slice DSCT is feasible for the evaluation of coronary arteries and cardiac function without heart rate control in patients in stable sinus rhythm at a low radiation dose.