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Assessment of vascular contrast and wall motion of the aortic root and ascending aorta on MDCT angiography: dual-source high-pitch vs non-gated single-source acquisition schemes

Abstract

Objectives

This retrospective study assessed whether dual-source high-pitch computed tomographic angiography (CTA) offered advantages over single-source standard-pitch techniques in the evaluation of the ascending aorta.

Methods

Twenty patients who received both thoracic dual-source high-pitch and single-source standard-pitch CTAs within 1 year were assessed. Dual-source CTAs were performed; standard-pitch imaging used dose-modulated 120 kVp/150 mAs and 0.8 pitch compared with high-pitch protocols employing dose-modulated 120 kVp/250 mAs and 2.4 target pitch. Radiation dose was documented. Contrast-to-noise ratios (CNRs) at sinuses of the Valsalva (CNRValsalva) and ascending aorta (CNRAorta) were calculated. Dose/CNR for each technique was compared with paired t-tests. Motion at aortic valve, aortic root and ascending aorta were assessed with four-point scales and Mann–Whitney U tests; longitudinal extension of motion was compared with paired t-tests.

Results

Significantly lower motion scores for high-pitch, compared with standard-pitch acquisitions for aortic annulus, 0 vs. 2, aortic root, 0 vs. 3, and ascending aorta, 0 vs. 2, were achieved. Significantly reduced longitudinal extension of motion at aortic root, 4.9 mm vs 15.7 mm, and ascending aorta, 4.9 mm vs 21.6 mm, was observed. Contrast was not impacted: CNRValsalva, 45.6 vs 46.3, and CNRAorta, 45.3 vs 47.1. CTDIvol was significantly decreased for high-pitch acquisitions, 13.9 mGy vs 15.8 mGy.

Conclusions

Dual-source high-pitch CTAs significantly decreased motion artefact without negatively impacting vascular contrast and radiation dose.

Key Points

Dual-source high-pitch CTA significantly decreased motion artefact of the ascending aorta.

Dual-source high-pitch CTA did not negatively impact on vascular contrast.

Dual-source high-pitch CTA significantly decreased radiation dose compared with single-source standard-pitch acquisitions.

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Acknowledgments

The scientific guarantor of this publication is Daniel T Boll, M.D., tenured senior author of this manuscript. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise—Daniel T Boll, M.D. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board due to the retrospective nature of this study. No study subjects or cohorts have been previously reported. Methodology: retrospective case–control study performed at one institution.

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Correspondence to Daniel T. Boll.

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Christensen, J.D., Seaman, D.M., Lungren, M.P. et al. Assessment of vascular contrast and wall motion of the aortic root and ascending aorta on MDCT angiography: dual-source high-pitch vs non-gated single-source acquisition schemes. Eur Radiol 24, 990–997 (2014). https://doi.org/10.1007/s00330-014-3120-2

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Keywords

  • Dual-source CT
  • Aorta
  • CT angiography
  • High-pitch acquisition
  • Motion artefact