Document Detail

Prospectively ECG-triggered high-pitch spiral acquisition for cardiac CT angiography in routine clinical practice: initial results.
MedLine Citation:
PMID:  21964497     Owner:  NLM     Status:  MEDLINE    
PURPOSE: This study was conducted to evaluate the mode of application, image quality (IQ), and radiation exposure resulting from introduction of a prospectively electrocardiogram-triggered high-pitch cardiac computed tomography angiography (CTA) acquisition mode into routine clinical practice.
MATERIALS AND METHODS: A total of 42 prospectively triggered cardiac CTAs were conducted on 34 patients (11 female, 23 male; mean age 56 ± 15 y) using a high-pitch mode (pitch 3.4) on a dual-source CT. In 8 of these patients with higher heart rates or occasional premature ventricular contractions, 2 immediately subsequent CTAs were performed ("double flash protocol"). Subjective IQ was assessed for coronary arteries using a 4-point scale (1=unevaluable to 4=excellent). Contrast-to-noise ratio (CNR) was measured in 9 locations. CT Dose Index and dose-length product were obtained, and the patients' effective dose was calculated.
RESULTS: Mean effective doses were 2.6 ± 1.4 mSv (range: 1.1 to 6.4) for the entire cardiac examination and 1.4 ± 0.7 mSv (0.4 to 3.1) for individual high-pitch cardiac CTA. z-coverage ranged from 9.9 cm in a native coronary CTA to 31.4 cm in a bypass graft case. The overall subjective IQ was good to excellent (mean score: 3.5), with 1.5% unevaluable coronary segments. The "double flash protocol" resulted in a fully diagnostic CT study in all cases just after taking both scans into consideration. The mean CNR of all locations was 19.7 ± 2.6.
CONCLUSION: Prospectively electrocardiograph-triggered high-pitch-mode cardiac CTA is a feasible and promising technique in clinical routine, allowing for evaluation of coronaries at good-to-excellent IQ and providing high CNR and minimal radiation doses. The "double flash protocol" might become a more robust tool in patients with elevated heart rates or premature ventricular contractions.
Patric Kröpil; Carlos A Rojas; Brian Ghoshhajra; Rotem S Lanzman; Falk R Miese; Axel Scherer; Mannudeep Kalra; Suhny Abbara
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thoracic imaging     Volume:  27     ISSN:  1536-0237     ISO Abbreviation:  J Thorac Imaging     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-17     Completed Date:  2012-08-13     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  8606160     Medline TA:  J Thorac Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  194-201     Citation Subset:  IM    
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MeSH Terms
Analysis of Variance
Cardiac-Gated Imaging Techniques / methods*
Contrast Media / diagnostic use
Coronary Angiography / methods*
Coronary Disease / radiography*
Iopamidol / diagnostic use
Linear Models
Middle Aged
Radiation Dosage
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Tomography, Spiral Computed / methods*
Grant Support
Reg. No./Substance:
0/Contrast Media; JR13W81H44/Iopamidol

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