心房颤动患者左房标测:高间距螺旋CT血管造影与回顾性ecg门控CT血管造影图像质量和辐射剂量的比较研究

Archives of Cardiovascular Imaging Pub Date : 2016-11-30 DOI:10.5812/ACVI.13307

Hamidreza Pooraliakbar, Maryam Khalili Sadrabad, Z. Emkanjoo, M. Haghjoo, Ahmadali Khalili Sadrabad

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引用次数: 0

摘要

背景:在保持诊断图像质量(IQ)的同时，试图减少心脏成像的辐射暴露是强制性的。使用高螺距螺旋双源计算机断层扫描(DSCT)方案进行左房(LA)测绘，我们试图确定心房颤动患者计划射频消融的IQ和辐射剂量。方法:59例患者(女性29例;平均年龄53岁)在2013年至2016年期间接受了CT血管造影:26例患者采用回顾性心电图门控(经典)，33例患者采用第二代128-DSCT系统(SOMATOM Definition Flash)的高分辨率(Flash)方案。将LA的CT图像整合到电子解剖系统(NavX)中。两名独立的盲法读者使用3分制量表和LA对比密度来评估智商。根据每个患者方案获得剂量-长度积(DLP)，并根据欧洲CT指南计算有效辐射剂量(ERD)。结果:闪灯组诊断性智商(3分或2分)率为87.9%，经典组为96.2%，两组间差异无统计学意义(P = 0.250)。客观IQ测量结果显示，经典组21张(80.8%)、闪光组26张(78.8%)中央LA对比密度大于350 Hounsfield单位(诊断值)，两组间差异无统计学意义(P = 0.850)。两组间DLP、ERD差异有统计学意义(P < 0.001)，高间距扫描的DLP、ERD值低于回顾性ecg门控扫描(分别为151.30±39.44∶776.61±243.63、2.11±0.55∶10.872±3.41)。结论:高频(Flash) DSCT是一种可接受的CT血管造影方法，可以在不影响房颤患者LA和肺静脉成像的IQ的情况下降低辐射剂量。

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Left Atrial Mapping in Patients with Atrial Fibrillation: A Comparison Study of Image Quality and Radiation Dose Between High-Pitch Spiral CT Angiography and Retrospective ECG-Gated CT Angiography

Background: Trying to reduce radiation exposure from cardiac imaging is mandatory while maintaining diagnostic image quality (IQ). Using a high-pitch spiral dual-source computed tomography (DSCT) protocol for left atrial (LA) mapping, we sought to determine IQ and radiation dose in patients with atrial fibrillation scheduled for radiofrequency ablation. Methods: Fifty-nine patients (29 women; mean age = 53 y) underwent CT angiography between 2013 and 2016: 26 patients with retrospective ECG-gated (classic) and 33 with high-pitch (Flash) protocols on a second-generation 128-DSCT system (SOMATOM Definition Flash). CT images of the LA were integrated into an electroanatomic system (NavX). Two independent blinded readers evaluated IQ using a 3-point scale and the LA contrast density. Dose-length product (DLP) was obtained from each patient protocol, and effective radiation dose (ERD) was calculated according to the European guideline for CT. Results: The rate of diagnostic IQ (score 3 or 2) was 87.9% for the flash group and 96.2% for the classic group, which was not significantly different between the 2 groups (P = 0.250). The results of objective IQ measurements showed that a central LA contrast density above 350 Hounsfield units (diagnostic) was present in 21 (80.8%) images in the classic group and 26 (78.8%) images in the flash group, which was not statistically different between the 2 groups (P = 0.850). There were significant differences (P < 0.001) in DLP and ERD between the 2 groups: the values were lower in high-pitch scan than in retrospective ECG-gated scan (151.30± 39.44 vs. 776.61 ± 243.63 and 2.11 ± 0.55 vs. 10.872 ± 3.41, respectively). Conclusions: High-pitch (Flash) DSCT is an acceptable CT angiography method for reducing radiation dose without compromising IQ for LA and pulmonary venous imaging in patients with atrial fibrillation.

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Archives of Cardiovascular Imaging

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