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Erschienen in: European Radiology 8/2011

01.08.2011 | Cardiac

Diagnostic accuracy of dual-source CT coronary angiography with prospective ECG-triggering on different heart rate patients

verfasst von: Ming-li Sun, Bin Lu, Run-ze Wu, Laura Johnson, Lei Han, Gang Liu, Fang-Fang Yu, Zhi-hui Hou, Yang Gao, Hong-yu Wang, Shiliang Jiang, Yue-jin Yang, Shu-bin Qiao

Erschienen in: European Radiology | Ausgabe 8/2011

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Abstract

Objective

To evaluate the diagnostic accuracy of dual-source CT (DSCT) prospective ECG-triggering coronary angiography in patients with different heart rate (HR).

Methods

103 patients with suspected coronary artery disease underwent DSCT prospective ECG-triggered coronary angiography and invasive coronary angiography (ICA). The patients were grouped by HR during CT scans: low HR (≤60 bpm, n = 34); medium HR (60 < HR ≤ 70 bpm, n = 36) and high HR (>70 bpm, n = 33). The sensitivity and specificity of DSCT in detecting ≥50% stenosis were compared among subgroups where ICA was the gold standard. Image quality was scored using a 4-point scale.

Results

A total of 1,580 (95.9%) coronary artery segments were evaluable. Sensitivity and specificity were 82.8% and 98.4%, 88.3% and 98.7%, and 80.3% and 98.6% for different subgroups (all p > 0.05). The overall area under the curve of the receiver-operating characteristic analysis was 0.94. The image quality scores were 3.1 ± 0.3, 3.1 ± 0.3 and 3.0 ± 0.4 for subgroups (p > 0.05). The overall average effective radiation dose was 3.60 ± 1.60 mSv.

Conclusion

DSCT coronary angiography with prospective ECG-triggering could be just as accurate in patients with medium to high HR compared to those with low HR.
Literatur
1.
Zurück zum Zitat Donald LJ, Robert JA, Todd MB et al (2010) Heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation 121:948–954CrossRef Donald LJ, Robert JA, Todd MB et al (2010) Heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation 121:948–954CrossRef
2.
Zurück zum Zitat Gaziano TA (2007) Reducing the growing burden of cardiovascular disease in the developing world. Health Aff 26:13–24CrossRef Gaziano TA (2007) Reducing the growing burden of cardiovascular disease in the developing world. Health Aff 26:13–24CrossRef
3.
Zurück zum Zitat Bastarrika G, Lee YS, Huda W et al (2009) CT of coronary artery disease. Radiology 253:317–338PubMedCrossRef Bastarrika G, Lee YS, Huda W et al (2009) CT of coronary artery disease. Radiology 253:317–338PubMedCrossRef
4.
Zurück zum Zitat Einstein AJ, Henzlova MJ, Rajagopalan S (2007) Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 298:317–323PubMedCrossRef Einstein AJ, Henzlova MJ, Rajagopalan S (2007) Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 298:317–323PubMedCrossRef
5.
Zurück zum Zitat Ketelsen D, Thomas C, Werner M et al (2010) Dual-source computed tomography: estimation of radiation exposure of ECG-gated and ECG-triggered coronary angiography. Eur J Radiol 73:274–279PubMedCrossRef Ketelsen D, Thomas C, Werner M et al (2010) Dual-source computed tomography: estimation of radiation exposure of ECG-gated and ECG-triggered coronary angiography. Eur J Radiol 73:274–279PubMedCrossRef
6.
Zurück zum Zitat Schoenhagen P (2008) Back to the future: coronary CT angiography using prospective ECG triggering. Eur Heart J 29:153–154PubMedCrossRef Schoenhagen P (2008) Back to the future: coronary CT angiography using prospective ECG triggering. Eur Heart J 29:153–154PubMedCrossRef
7.
Zurück zum Zitat Ko SM, Kim NR, Kim DH et al (2010) Assessment of image quality and radiation dose in prospective ECG-triggered coronary CT angiography compared with retrospective ECG-gated coronary CT angiography. Int J Cardiovasc Imaging 26:93–101PubMedCrossRef Ko SM, Kim NR, Kim DH et al (2010) Assessment of image quality and radiation dose in prospective ECG-triggered coronary CT angiography compared with retrospective ECG-gated coronary CT angiography. Int J Cardiovasc Imaging 26:93–101PubMedCrossRef
8.
Zurück zum Zitat Klass O, Jeltsch M, Feuerlein S et al (2009) Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique. Eur Radiol 19:829–836PubMedCrossRef Klass O, Jeltsch M, Feuerlein S et al (2009) Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique. Eur Radiol 19:829–836PubMedCrossRef
9.
Zurück zum Zitat Earls JP, Berman E, Urban BA et al (2008) Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique: improved image quality and reduced radiation dose. Radiology 246:742–753PubMedCrossRef Earls JP, Berman E, Urban BA et al (2008) Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique: improved image quality and reduced radiation dose. Radiology 246:742–753PubMedCrossRef
10.
Zurück zum Zitat Alkadhi H, Stolzmann P, Scheffel H et al (2008) Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters. Eur J Radiol 68:385–391PubMedCrossRef Alkadhi H, Stolzmann P, Scheffel H et al (2008) Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters. Eur J Radiol 68:385–391PubMedCrossRef
11.
Zurück zum Zitat Pflederer T, Jakstat J, Marwan M et al (2010) Radiation exposure and image quality in staged low-dose protocols for coronary dual-source CT angiography: a randomized comparison. Eur Radiol 20:1197–1206PubMedCrossRef Pflederer T, Jakstat J, Marwan M et al (2010) Radiation exposure and image quality in staged low-dose protocols for coronary dual-source CT angiography: a randomized comparison. Eur Radiol 20:1197–1206PubMedCrossRef
12.
Zurück zum Zitat Hein F, Meyer T, Hadamitzky M et al (2009) Prospective ECG-triggered sequential scan protocol for coronary dual-source CT angiography: initial experience. Int J Cardiovasc Imaging 25:231–239CrossRef Hein F, Meyer T, Hadamitzky M et al (2009) Prospective ECG-triggered sequential scan protocol for coronary dual-source CT angiography: initial experience. Int J Cardiovasc Imaging 25:231–239CrossRef
13.
Zurück zum Zitat Scheffel H, Alkadhi H, Leschka S et al (2008) Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance. Heart 94:1132–1137PubMedCrossRef Scheffel H, Alkadhi H, Leschka S et al (2008) Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance. Heart 94:1132–1137PubMedCrossRef
14.
Zurück zum Zitat Herzog BA, Husmann L, Burkhard N et al (2008) Accuracy of low-dose computed tomography coronary angiography using prospective electrocardiogram-triggering: first clinical experience. Eur Heart J 29:3037–3042PubMedCrossRef Herzog BA, Husmann L, Burkhard N et al (2008) Accuracy of low-dose computed tomography coronary angiography using prospective electrocardiogram-triggering: first clinical experience. Eur Heart J 29:3037–3042PubMedCrossRef
15.
Zurück zum Zitat Achenbach S, Anders K, Kalender WA (2008) Dual-source cardiac computed tomography: image quality and dose considerations. Eur Radiol 18:1188–1198PubMedCrossRef Achenbach S, Anders K, Kalender WA (2008) Dual-source cardiac computed tomography: image quality and dose considerations. Eur Radiol 18:1188–1198PubMedCrossRef
16.
Zurück zum Zitat Srichai MB, Hecht EM, Kim D et al (2009) Dual-Source computed tomography angiography image quality in patients with fast heart rates. J Cardiovasc Comput Tomogr 3:300–309PubMedCrossRef Srichai MB, Hecht EM, Kim D et al (2009) Dual-Source computed tomography angiography image quality in patients with fast heart rates. J Cardiovasc Comput Tomogr 3:300–309PubMedCrossRef
17.
Zurück zum Zitat Maruyama T, Takada M, Hasuike T et al (2008) Radiation dose reduction and coronary assessability of prospective electrocardiogram-gated computed tomography coronary angiography: comparison with retrospective electrocardiogram-gated helical scan. J Am Coll Cardiol 52:1450–1455PubMedCrossRef Maruyama T, Takada M, Hasuike T et al (2008) Radiation dose reduction and coronary assessability of prospective electrocardiogram-gated computed tomography coronary angiography: comparison with retrospective electrocardiogram-gated helical scan. J Am Coll Cardiol 52:1450–1455PubMedCrossRef
18.
Zurück zum Zitat Husmann L, Valenta I, Gaemperli O et al (2008) Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. Eur Heart J 29:191–197PubMedCrossRef Husmann L, Valenta I, Gaemperli O et al (2008) Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. Eur Heart J 29:191–197PubMedCrossRef
19.
Zurück zum Zitat Alkadhi H, Scheffel H, Desbiolles L et al (2008) Dual-source computed tomography coronary angiography: influence of obesity, calcium load, and heart rate on diagnostic accuracy. Eur Heart J 29:766–776PubMedCrossRef Alkadhi H, Scheffel H, Desbiolles L et al (2008) Dual-source computed tomography coronary angiography: influence of obesity, calcium load, and heart rate on diagnostic accuracy. Eur Heart J 29:766–776PubMedCrossRef
20.
Zurück zum Zitat Rixe J, Rolf A, Conradi G et al (2008) Image quality on dual-source computed-tomographic coronary angiography. Eur Radiol 18:1857–1862PubMedCrossRef Rixe J, Rolf A, Conradi G et al (2008) Image quality on dual-source computed-tomographic coronary angiography. Eur Radiol 18:1857–1862PubMedCrossRef
21.
Zurück zum Zitat Rixe J, Rolf A, Conradi G et al (2009) Detection of relevant coronary artery disease using dual-source computed tomography in a high probability patient series: comparison with invasive angiography. Circ J 73:316–322PubMedCrossRef Rixe J, Rolf A, Conradi G et al (2009) Detection of relevant coronary artery disease using dual-source computed tomography in a high probability patient series: comparison with invasive angiography. Circ J 73:316–322PubMedCrossRef
22.
Zurück zum Zitat Ropers U, Ropers D, Pflederer T et al (2007) Influence of heart rate on the diagnostic accuracy of dual-source computed tomography coronary angiography. J Am Coll Cardiol 50:2393–2398PubMedCrossRef Ropers U, Ropers D, Pflederer T et al (2007) Influence of heart rate on the diagnostic accuracy of dual-source computed tomography coronary angiography. J Am Coll Cardiol 50:2393–2398PubMedCrossRef
23.
Zurück zum Zitat Lu B, Mao SS, Zhuang N et al (2001) Coronary artery motion during the cardiac cycle and optimal ECG triggering for coronary artery imaging. Invest Radiol 36:250–256PubMedCrossRef Lu B, Mao SS, Zhuang N et al (2001) Coronary artery motion during the cardiac cycle and optimal ECG triggering for coronary artery imaging. Invest Radiol 36:250–256PubMedCrossRef
24.
Zurück zum Zitat Lell M, Marwan M, Schepis T et al (2009) Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience. Eur Radiol 19:2576–2583PubMedCrossRef Lell M, Marwan M, Schepis T et al (2009) Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience. Eur Radiol 19:2576–2583PubMedCrossRef
25.
Zurück zum Zitat Xu Y, Tang LJ, Zhu XM et al (2010) Comparison of dual-source CT coronary angiography and conventional coronary angiography for detecting coronary artery disease. Int J Cardiovasc Imaging 26:75–81PubMedCrossRef Xu Y, Tang LJ, Zhu XM et al (2010) Comparison of dual-source CT coronary angiography and conventional coronary angiography for detecting coronary artery disease. Int J Cardiovasc Imaging 26:75–81PubMedCrossRef
26.
Zurück zum Zitat Herzog BA, Wyss CA, Husmann L et al (2009) First head-to-head comparison of effective radiation dose from low-dose 64-slice CT with prospective ECG-triggering versus invasive coronary angiography. Heart 95:1656–1661PubMedCrossRef Herzog BA, Wyss CA, Husmann L et al (2009) First head-to-head comparison of effective radiation dose from low-dose 64-slice CT with prospective ECG-triggering versus invasive coronary angiography. Heart 95:1656–1661PubMedCrossRef
Metadaten
Titel
Diagnostic accuracy of dual-source CT coronary angiography with prospective ECG-triggering on different heart rate patients
verfasst von
Ming-li Sun
Bin Lu
Run-ze Wu
Laura Johnson
Lei Han
Gang Liu
Fang-Fang Yu
Zhi-hui Hou
Yang Gao
Hong-yu Wang
Shiliang Jiang
Yue-jin Yang
Shu-bin Qiao
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 8/2011
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2107-5

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