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Dual-step prospective ECG-triggered 128-slice dual-source CT for evaluation of coronary arteries and cardiac function without heart rate control: a technical note

Feuchtner, Gudrun ; Götti, Robert ; Plass, Andrè ; Baumueller, Stephan ; Stolzmann, Paul ; Scheffel, Hans ; Wieser, Monika ; Marincek, Borut ; Alkadhi, Hatem ; Leschka, Sebastian

In: European Radiology, 2010, vol. 20, no. 9, p. 2092-2099

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    Titre
    • Dual-step prospective ECG-triggered 128-slice dual-source CT for evaluation of coronary arteries and cardiac function without heart rate control: a technical note
    Auteur
    • Feuchtner, Gudrun. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Götti, Robert. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Plass, Andrè. Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland
    • Baumueller, Stephan. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Stolzmann, Paul. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Scheffel, Hans. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Wieser, Monika. Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland
    • Marincek, Borut. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Alkadhi, Hatem. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Leschka, Sebastian. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:317521
    Summary
    Purpose: To describe prospective ECG-triggered dual-source CT dual-step pulsing (pECGdual_step) for evaluation of coronary arteries and cardiac function. Methods: Fifty-one consecutive patients pre- or post-cardiovascular surgery were examined with adaptive sequential tube current modulated (pECGdual-step) 128-slice dual-source CT without heart rate control (main padding window: 40% RR interval >65bpm/70% RR interval <65bpm). Image quality of coronary arteries was graded (4-point scale), and cardiac function was evaluated. Results: Mean HR was 68bpm. Thirty-seven patients were in stable sinus rhythm (SR); 14 had arrhythmia. Image quality of coronary arteries was diagnostic in 804/816 (98%) of segments. The number of non-diagnostic segments was higher in patients with arrhythmia as compared to those in SR (4% vs. 0.5%; p = 0.01), and there were fewer segments with excellent image quality (79% vs. 94%; p < 0.001) and more segments with impaired image quality (p < 0.001 and p = 0.002). Global and regional LV function could be evaluated in 41 (80%) and 47 (92%) patients, and valvular function in 48 (94%). In 11/14 of patients with arrhythmia, the second step switched to full mAs, increasing radiation exposure to 8.6mAs (p < 0.001). The average radiation dose was 3.8mSv (range, 1.7-7.9) in patients in SR. Conclusion: pECGdual-step128-slice DSCT is feasible for the evaluation of coronary arteries and cardiac function without heart rate control in patients in stable sinus rhythm at a low radiation dose