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Erschienen in:
01.08.2010 | Cardiac
Imaging of pulmonary vein anatomy using low-dose prospective ECG-triggered dual-source computed tomography
Erschienen in: European Radiology | Ausgabe 8/2010
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Objective
To prospectively investigate the feasibility, image quality and radiation dose estimates for computed tomography angiography (CTA) of the pulmonary veins and left atrium using prospective electrocardiography (ECG)-triggered sequential dual-source (DS) data acquisition at end-systole in patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation.
Methods
Thirty-five patients (mean age 66.2 ± 12.6 years) with paroxysmal atrial fibrillation underwent prospective ECG-triggered sequential DS-CTA with tube current (250 mAs/rotation) centred 250 ms past the R-peak. Tube voltage was adjusted to the BMI (<25 kg/m2: 100 kV, >25 kg/m2: 120 kV). Presence of motion or stair-step artefacts was assessed. Effective radiation dose was calculated from the dose-length product.
Results
All data sets could be integrated into the electroanatomical mapping system. Twenty-two patients (63%) were in sinus rhythm (mean heart rate 69.2 ± 11.1 bpm, variability 1.0 ± 1.7 bpm) and 13 (37%) showed an ECG pattern of atrial fibrillation (mean heart rate 84.8 ± 16.6 bpm, variability 17.9 ± 7.5 bpm). Minor step artefacts were observed in three patients (23%) with atrial fibrillation. Mean estimated effective dose was 1.1 ± 0.3 and 3.0 ± 0.5 mSv for 100 and 120 kV respectively.
Conclusion
Imaging of pulmonary vein anatomy is feasible using prospective ECG-triggered sequential data acquisition at end-systole regardless of heart rate or rhythm at the benefit of low radiation dose.