Prospective ECG-gated coronary 320-MDCT angiography with absolute acquisition delay strategy for patients with persistent atrial fibrillation.
Prospective ECG-gated coronary 320-MDCT angiography with absolute acquisition delay strategy for patients with persistent atrial fibrillation.
复制标题
针对持续性心房颤动患者采用绝对采集延迟策略的前瞻性心电图门控冠状动脉 320-MDCT 血管造影。
DOI：
10.2214/ajr.12.10140
复制
发表时间：
2013
期刊：
影响因子：
--
通讯作者：
F. Rybicki
中科院分区：
文献类型：
--
作者：
T. Kondo;K. Kumamaru;S. Fujimoto;H. Matsutani;Tomonari Sano;S. Takase;F. Rybicki
客观化
本研究的目的是评估心房颤动患者接受冠状动脉CT血管成像(CTA)时的图像质量和辐射剂量。
材料和方法
一组连续的75例患者(男性60例，女性15例；年龄(±SD)，71±10岁)在房颤期间使用320-MDCT扫描仪行心电门控冠状动脉CTA，并与75例在窦性心律下成像的对照患者进行匹配。所有房颤患者的冠状动脉CTA均采用绝对延迟策略。比较两组患者的主观图像质量评分和剂量长度乘积(DLP)，对于房颤患者，比较不同心跳次数的患者的主观图像质量评分和剂量长度乘积。以导管血管造影术为参考标准，对17项房颤队列研究中狭窄检测的准确性进行了评估。
结果
在心房颤动患者中，26.7%(n=20)和40%(n=30)的患者分别进行了一拍和二拍采集。心房颤动组(2.9±0.4)和窦性心律组(2.9±0.3)的图像质量无显著差异，采集时使用的心跳次数也没有差异。房颤组DLP较对照组高80%(680±470vs372±236mGy×cm，P<0.0001)。以患者为基础检测狭窄的敏感性和阴性预测值均为100%。
结论
使用绝对延迟策略，使用320-MDCT扫描仪接受预期心电门控冠状动脉CTA的患者中，三分之二的患者在两次或更少的心跳内成像。与窦性心律成像的患者相比，图像质量相当，辐射剂量高1.8倍。
OBJECTIVE
The purpose of this study was to evaluate image quality and radiation dose when patients with atrial fibrillation undergo coronary CT angiography (CTA) using prospectively ECG-gated 320-MDCT technology with an absolute-delay strategy.
MATERIALS AND METHODS
A cohort of 75 consecutive patients (60 men and 15 women; age (± SD), 71 ± 10 years) who underwent prospectively ECG-gated coronary CTA using a 320-MDCT scanner during atrial fibrillation was matched with 75 control patients imaged in sinus rhythm. All coronary CTA for the atrial fibrillation cohort used absolute-delay strategy. Subjective image quality score and the dose-length product (DLP) were compared between the two cohorts and, for the atrial fibrillation cohort, among those patients imaged over a different number of heartbeats. The accuracy of stenosis detection was evaluated in 17 studies of the atrial fibrillation cohort using catheter angiography as a reference standard.
RESULTS
For those patients imaged in atrial fibrillation, one- and two-beat acquisitions were performed in 26.7% (n = 20) and 40% (n = 30) of patients, respectively. There was no significant difference in image quality between the atrial fibrillation (2.9 ± 0.4) and sinus rhythm (2.9 ± 0.3) cohorts, nor was there a difference in image quality with respect to the number of heartbeats used in the acquisition. The atrial fibrillation cohort had an 80% higher DLP (680 ± 470 vs 372 ± 236 mGy × cm, p < 0.0001). The patient-based sensitivity and negative predictive value for stenosis detection were both 100%.
CONCLUSION
Using an absolute-delay strategy, two thirds of patients who underwent prospectively ECG-gated coronary CTA using a 320-MDCT scanner were imaged within two heartbeats or fewer. Compared with patients imaged in sinus rhythm, the image quality was comparative and the radiation dose was 1.8-fold higher.