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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

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Abstract

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 >65 bpm/70% RR interval <65 bpm). Image quality of coronary arteries was graded (4-point scale), and cardiac function was evaluated.

Results

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.

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.

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Authors and Affiliations

  1. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland

    Gudrun Feuchtner, Robert Götti, Stephan Baumueller, Paul Stolzmann, Hans Scheffel, Borut Marincek, Hatem Alkadhi & Sebastian Leschka

  2. Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland

    Andrè Plass, Stephan Baumueller, Paul Stolzmann, Hans Scheffel & Monika Wieser

  3. Department of Radiology II, Innsbruck Medical University, Anichstrasse 35, A-6020, Innsbruck, Austria

    Gudrun Feuchtner

Authors
  1. Gudrun Feuchtner
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  2. Robert Götti
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  3. Andrè Plass
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  4. Stephan Baumueller
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  5. Paul Stolzmann
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  6. Hans Scheffel
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  8. Borut Marincek
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  9. Hatem Alkadhi
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  10. Sebastian Leschka
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Corresponding author

Correspondence to Gudrun Feuchtner.

Electronic supplementary materials

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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Feuchtner, G., Götti, R., Plass, A. et al. 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. Eur Radiol 20, 2092–2099 (2010). https://doi.org/10.1007/s00330-010-1794-7

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  • DOI: https://doi.org/10.1007/s00330-010-1794-7

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