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
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To describe prospective ECG-triggered dual-source CT dual-step pulsing (pECGdual_step) for evaluation of coronary arteries and cardiac function.
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 >65 bpm/70% RR interval <65 bpm). Image quality of coronary arteries was graded (4-point scale), and cardiac function was evaluated.
Mean HR was 68 bpm. 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 8.6 mAs (p < 0.001). The average radiation dose was 3.8 mSv (range, 1.7–7.9) in patients in SR.
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.
KeywordsComputed tomography Coronary arteries Cardiac function Prospective ECG triggering Radiation dose
Valvular function: 4D cine loops (corresponding movie to Fig. 1) show opening and closure of combined stenosed and regurgitant aortic valve during entire cardiac cycle. (AVI 3,239 kb)
Mechanical prosthetic valve: 4D cine loops during entire cardiac cycle, normal function (corresponding movie to Fig. 3) (AVI 1,949 kb)
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