Document Detail


128-slice Dual-source Computed Tomography Coronary Angiography in Patients with Atrial Fibrillation: Image Quality and Radiation Dose of Prospectively Electrocardiogram-triggered Sequential Scan Compared with Retrospectively Electrocardiogram-gated Spiral Scan.
MedLine Citation:
PMID:  23294583     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective To evaluate the image quality (IQ) and radiation dose of 128-slice dual-source computed tomography (DSCT) coronary angiography using prospectively electrocardiogram (ECG)-triggered sequential scan mode compared with ECG-gated spiral scan mode in a population with atrial fibrillation. Methods Thirty-two patients with suspected coronary artery disease and permanent atrial fibrillation referred for a second-generation 128-slice DSCT coronary angiography were included in the prospective study. Of them, 17 patients (sequential group) were randomly selected to use a prospectively ECG-triggered sequential scan, while the other 15 patients (spiral group) used a retrospectively ECG-gated spiral scan. The IQ was assessed by two readers independently, using a four-point grading scale from excel-lent (grade 1) to non-assessable (grade 4), based on the American Heart Association 15-segment model. IQ of each segment and effective dose of each patient were compared between the two groups. Results The mean heart rate (HR) of the sequential group was 96±27 beats per minute (bpm) with a variation range of 73±25 bpm, while the mean HR of the spiral group was 86±22 bpm with a variationrange of 65±24 bpm. Both of the mean HR (t=1.91, P=0.243) and HR variation range (t=0.950, P=0.350) had no significant difference between the two groups. In per-segment analysis, IQ of the sequential group vs. spiral group was rated as excellent (grade 1) in 190/244 (78%) vs. 177/217 (82%) by reader1 and 197/245 (80%) vs. 174/214 (81%) by reader2, as non-assessable (grade 4) in 4/244 (2%) vs. 2/217 (1%) by reader1 and 6/245 (2%) vs. 4/214 (2%) by reader2. Overall averaged IQ per-patient in the sequential and spiral group showed equally good (1.27±0.19 vs. 1.25±0.22, Z=-0.834, P=0.404). The effective radiation dose of the sequential group reduced significantly compared with the spiral group (4.88±1.77 mSv vs. 10.20±3.64 mSv; t=-5.372, P=0.000). Conclusion Compared with retrospectively ECG-gated spiral scan, prospectively ECG-triggered sequential DSCT coronary angiography provides similarly diagnostically valuable images in patients with atrial fibrillation and significantly reduces radiation dose.
Authors:
Lu Lin; Yi-Ning Wang; Ling-Yan Kong; Zheng-Yu Jin; Guang-Ming Lu; Zhao-Qi Zhang; Jian Cao; Shuo Li; Lan Song; Zhi-Wei Wang; Kang Zhou; Ming Wang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chinese medical sciences journal = Chung-kuo i hsüeh k'o hsüeh tsa chih / Chinese Academy of Medical Sciences     Volume:  27     ISSN:  1001-9294     ISO Abbreviation:  Chin. Med. Sci. J.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9112559     Medline TA:  Chin Med Sci J     Country:  China    
Other Details:
Languages:  eng     Pagination:  195-200     Citation Subset:  IM    
Affiliation:
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
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