Radiation dose reduction and coronary assessability of prospective electrocardiogram-gated computed tomography coronary angiography: comparison with retrospective electrocardiogram-gated helical scan.
Radiation dose reduction and coronary assessability of prospective electrocardiogram-gated computed tomography coronary angiography: comparison with retrospective electrocardiogram-gated helical scan.
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前瞻性心电图门控计算机断层扫描冠状动脉造影的辐射剂量减少和冠状动脉评估：与回顾性心电图门控螺旋扫描的比较。
DOI：
10.1016/j.jacc.2008.07.048
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发表时间：
2008
影响因子：
24
通讯作者：
T. Yoshizumi
中科院分区：
文献类型：
--
作者：
T. Maruyama;M. Takada;T. Hasuike;A. Yoshikawa;Eiji Namimatsu;T. Yoshizumi
ObjectivesThe的目的，这项研究的目的是评估辐射剂量和冠状动脉评估的前瞻性心电图（ECG）门控扫描64层多探测器（行）计算机断层扫描（MDCT）冠状动脉造影（CA）相比，回顾性心电图门控螺旋scanes.BackgroundThe 64层MDCT-CA已被广泛使用，但是，高辐射剂量的64层MDCT-CA已被报道。前瞻性心电门控扫描，使用“步进和拍摄”协议，可以减少辐射照射effectively。五十六例患者因心率>65次/分而被排除;在心率≤65次/分的患者中，97例通过管电流调制螺旋扫描进行分析，76例通过前瞻性门控进行分析。冠状动脉的可评估性和诊断准确性进行了研究，与选择性CA作为金标准。两个protocol.ResultsCoronary螺旋扫描的可评估性为95.5%（1,303 1,364段），而前瞻性门控为96.6%（1,053 1,089段），显示相似的冠状动脉可评估性（p = 0.14）。螺旋扫描对可评估节段中冠状动脉阻塞性和闭塞性病变的敏感性和特异性分别为97.0%（162/167）和97.6%（1109/1136），而前瞻性门控分别为96.4%（81/84，p = 0.84）和98.5%（955/969，p = 0.12）。螺旋扫描和前瞻性门控的有效剂量分别为21.1 ± 6.7mSv和4.3 ± 1.3mSv（p < 0.0001），显示前瞻性门控比螺旋扫描减少了79%的辐射剂量。结论前瞻性门控MDCT-CA显示与回顾性ECG相比，门控螺旋扫描与管电流调制。
ObjectivesThe aim of this study was to evaluate radiation dose and coronary assessability of a prospective electrocardiogram (ECG)-gated scan by 64-slice multidetector (row) computed tomography (MDCT)-coronary angiography (CA) compared with a retrospective ECG-gated helical scan.BackgroundThe 64-slice MDCT-CA has been widely used; however, a high radiation dose by 64-slice MDCT-CA has been reported. Prospective ECG-gated scan using “step-and-shoot” protocol can reduce radiation exposure effectively.MethodsMDCT-CA was performed in 229 consecutive patients. Fifty-six patients were excluded because of higher heart rates of >65 beats/min; of patients with heart rates ≤65 beats/min, 97 were analyzed by helical scan with tube current modulation and 76 were analyzed by prospective gating. Coronary assessability and diagnostic accuracy were investigated in comparison with selective CA as the gold standard. Radiation doses were evaluated in both protocols.ResultsCoronary assessability of helical scan was 95.5% (1,303 of 1,364 segments), while that of prospective gating was 96.6% (1,053 of 1,089 segments), showing similar coronary assessability (p = 0.14). Sensitivity and specificity for coronary obstructive and occlusive lesions in the assessable segments were 97.0% (162 of 167) and 97.6% (1,109 of 1,136) by helical scan, while those of prospective gating were 96.4% (81 of 84, p = 0.84) and 98.5% (955 of 969, p = 0.12), respectively. Effective doses of helical scan and prospective gating were 21.1 ± 6.7 mSv and 4.3 ± 1.3 mSv, respectively (p < 0.0001), showing that prospective gating decreased radiation dose by 79% compared with that of helical scan.ConclusionsMDCT-CA by prospective gating showed equivalent coronary assessability and diagnostic accuracy with decreased radiation dose in comparison with a retrospective ECG-gated helical scan with tube current modulation.