Clinical application of electrocardiogram-triggered high-pitch dual-source coronary CT angiography at 80 kV low radiation dose integrated iterative reconstruction technology

doi:10.3877/cma.j.issn.2095-655X.2017.01.001

Abstract

Abstract:

Objective

To assess the impact of image quality and radiation dose levels of low tube potential with electrocardiogram (ECG)-triggered high-pitch coronary computed tomography angiography (CCTA) of 2nd generation dual-source computed tomography.

Methods

One hundred and twenty patients with suspected coronary arteries underwent high-pitch prospectively ECG-triggering CCTA.All subjects had registered for this research and hospitalized.Prospective study was conducted with dual-source coronary computed tomography using iodine contrast agents.All patients signed informed consent of the Ethical Committee of Baotou Central Hospital and the ethics committees approved the consent procedure.Sixty patients were examined with high-pitch mode by a 2nd-generation dual-source CT system at 80 kV and SAFIRE iterative reconstruction (80 kV+ SAFIRE) or with 80 or 100 kV and FBP reconstruction (80 kV+ FBP, 100 kV+ FBP) respectively.Subjective image quality was evaluated double-blindly by two experienced radiologists.Objective image quality was measured by means of various regions of interest.

Results

The noise values of aortic root, right coronary artery(RCA), left coronary artery(LAM) in 80 kV+ SAFIRE group (23.62±5.57, 18.89±8.80, 17.42±5.94) were lower than those of 80 kV+ FBP group(31.66±8.41, 24.15±15.84, 22.45±5.62) as well as 100 kV+ FBP group(27.38±8.01, 22.76±4.41, 22.09±4.51), the differences were significant (F=19.09, 4.36, 22.15; P<0.05). The signal to noise ratios (SNR) of aortic root, RCA, LAM in 80 kV+ SAFIRE group (24.89±8.37, 32.33±12.80, 34.46±11.73) were higher than those of 80 kV+ FBP group (18.84±6.43, 24.89±9.08, 25.70±7.90) and 100 kV+ FBP group (19.66±4.43, 24.12±7.35, 24.93±7.86) , the differences were also significant (F=21.08, 16.69, 26.55; P<0.01). The effective dose (ED) of 80 kV+ SAFIRE , 80 kV+ FBP groups decreased significantly compared with 100 kV+ FBP group (F=38.14; P<0.01). The ED of three group were (0.47±0.03)mSv, (0.47±0.05)mSv, (1.00±0.04)mSv respectively.

Conclusions

High-pitch prospectively ECG-triggered CCTA at 80 kV enables to obtain diagnostic image quality with 2nd-generation CT using iterative reconstruction technique in patients.This methodology can reduce radiation dose levels obviously compared with the 100 kV group.The radiation dose of the 80 kV group is reduced by 53%.

Key words: Coronary vessels, Tomography, x-ray computed, Image processing, computer-assisted

Yang Han, Ruijuan Han, Guoqiang Chen, Ruiping Zhao, Kai Sun. Clinical application of electrocardiogram-triggered high-pitch dual-source coronary CT angiography at 80 kV low radiation dose integrated iterative reconstruction technology[J]. Chinese Journal of Diagnostics(Electronic Edition), 2017, 05(01): 1-7.

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Figures/Tables 8

References 18

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项目	80 kV＋ SAFIRE组	80 kV＋ FBP组	100 kV＋ FBP组
管电压(kV)	80 kV	80 kV	100 kV
管电流(mAs)	370 mAs	370 mAs	370 mAs
CTA采集模式	Flash模式	Flash模式	Flash模式
扫描长度(Z轴)	气管分叉下2 cm至膈面	气管分叉下2 cm至膈面	气管分叉下2 cm至膈面
RR%间期	55%	55%	55%
层厚(mm)	0.75	0.75	0.75
层间距(mm)	0.50	0.50	0.50
准直器(mm)	2×64×0.6	2×64×0.6	2×64×0.6
重建方法	SAFIRE	FBP	FBP
重建核	B26f	B26f	B26f

项目	80 kV＋ SAFIRE组	80 kV＋ FBP组	100 kV＋ FBP组
管电压(kV)	80 kV	80 kV	100 kV
管电流(mAs)	370 mAs	370 mAs	370 mAs
CTA采集模式	Flash模式	Flash模式	Flash模式
扫描长度(Z轴)	气管分叉下2 cm至膈面	气管分叉下2 cm至膈面	气管分叉下2 cm至膈面
RR%间期	55%	55%	55%
层厚(mm)	0.75	0.75	0.75
层间距(mm)	0.50	0.50	0.50
准直器(mm)	2×64×0.6	2×64×0.6	2×64×0.6
重建方法	SAFIRE	FBP	FBP
重建核	B26f	B26f	B26f

组别	例数	年龄(岁)	心率(次/min)	BMI(kg/m²)	扫描时间(ms)
80 kV组	60	60.00±10.00	60.00±5.00	23.99±3.92	248.00±21.00
100 kV组	60	60.00±12.00	62.00±4.00	24.89±3.65	252.00±22.00
t值	?	－0.01	1.87	－1.29	－13.40
P值	?	0.99	0.42	0.21	0.14

组别	例数	年龄(岁)	心率(次/min)	BMI(kg/m²)	扫描时间(ms)
80 kV组	60	60.00±10.00	60.00±5.00	23.99±3.92	248.00±21.00
100 kV组	60	60.00±12.00	62.00±4.00	24.89±3.65	252.00±22.00
t值	?	－0.01	1.87	－1.29	－13.40
P值	?	0.99	0.42	0.21	0.14

项目	80 kV＋SAFIRE组(n＝60)	80 kV＋FBP组(n＝60)	100 kV＋FBP组(n＝60)	F值	P值	P值(两两比较)
项目	80 kV＋SAFIRE组(n＝60)	80 kV＋FBP组(n＝60)	100 kV＋FBP组(n＝60)	F值	P值	P₁值	P₂值	P₃值
主动脉根部CT值	556.00±112.38	558.30±116.20	516.60±92.01	5.53	<0.01	>0.05	<0.05	<0.05
RCA CT值	540.60±138.19	532.80±123.30	526.00±101.20	0.47	>0.05	>0.05	>0.05	>0.05
LAM CT值	557.00±132.82	546.50±114.82	524.96±92.88	1.84	>0.05	>0.05	>0.05	>0.05
周围脂肪组织CT值	－107.30±26.53	－110.50±52.16	－95.11±28.72	2.78	>0.05	>0.05	>0.01	>0.01
主动脉根部噪声值	23.66± 5.57	31.62± 8.41	27.38± 8.01	19.09	<0.05	<0.01	<0.01	<0.01
RCA噪声值	18.89± 8.80	24.15±15.84	22.76± 4.41	4.36	<0.05	>0.01	<0.01	>0.05
LAM噪声值	17.42± 5.94	22.45± 5.62	22.09± 4.51	22.15	<0.01	<0.01	<0.01	>0.05
主动脉根部信噪比值	24.89± 8.37	18.84± 6.43	19.66± 4.43	21.08	<0.01	<0.01	<0.01	>0.05
RCA信噪比值	32.33±12.80	24.89± 9.08	24.12± 7.35	16.69	<0.01	<0.01	<0.01	>0.05
LAM信噪比值	34.46±11.73	25.70± 7.90	24.93± 7.86	26.55	<0.01	<0.01	<0.01	>0.05
主动脉根部对比信噪比值	29.64± 9.05	22.53± 7.17	23.37± 5.19	22.58	<0.01	<0.01	<0.01	>0.05
RCA对比信噪比值	38.67±14.11	30.13±10.47	32.42±12.00	18.43	<0.01	<0.01	<0.01	>0.05
LAM对比信噪比值	41.07±13.04	29.46± 9.10	33.82±11.74	28.76	<0.01	<0.01	<0.01	>0.05
射线剂量DLP(mGy/cm)	33.63± 2.20	33.83± 3.33	71.81± 2.98	38.14	<0.01	>0.05	<0.01	<0.01
有效辐射剂量(mSv)	0.47± 0.03	0.47± 0.05	1.00± 0.04	38.14	<0.01	>0.05	<0.01	<0.01
平均图像质量的评分(分)	1.05± 0.33	1.05± 0.33	1.07± 0.27	16.54	<0.14	—	>0.05	>0.05

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