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ABSTRACT: To evaluate the value of dual-source computed tomography (DSCT) in quantitatively measuring pulmonary arteries and major aortopulmonary collateral vessels in comparison with conventional angiographic (CA) on preoperative patients with pulmonary artery atresia and ventricular septal defect (PAA-VSD).
Twenty PAA-VSD patients who had complete imaging data of DSCT, CA and echocardiography (ECHO) studies were retrospectively analyzed. Using final clinical diagnosis as the standard, results of DSCT, CA and ECHO on the detection of cardiac malformations, measurement of diameters of pulmonary artery and collateral vessel, as well as the values of McGoon ratio, pulmonary arterial index (PAI) and total neopulmonary arterial index (TNPAI) were derived and compared.
In 20 patients, 51 of 54 (94.4%) cardiac malformations were visualized by DSCT, whereas 42 (77.8%) by ECHO (p = 0.027). Fourteen cases with aortopulmonary collateral vessels were all (100%) detected by DSCT, whereas 5 cases (35.7%) by ECHO (p = 0.001), and 13 cases (92.9%) by CA (p = 0.995). Sixteen cases with confluence of native pulmonary arteries were diagnosed by DSCT, whereas 10 cases by CA (p = 0.024). Measurement of the diameters of pulmonary arteries, collateral vessels, and descending aorta at the level of diaphragm were correlated well between DSCT and CA (r = 0.95-0.99). McGoon ratio (DSCT=1.18 ± 0.60, CA = 1.23 ± 0.64), PAI (DSCT=130.96 ± 99.38 mm²/m², CA = 140.91 ± 107.87 mm²/m²) and TNPAI (DSCT=160.31 ± 125.62 mm²/m², CA = 169.14 ± 122.81 mm²/m²) were calculated respectively, without significant differences between DSCT and CA by paired t-tests (all p > 0.05).
DSCT was efficient for evaluating and measuring native pulmonary artery and aortopulmonary collateral vessels prior to surgical procedures in PAA-VSD patients. Combined with echocardiography, DSCT showed potential to replace CA for evaluating pulmonary artery atresia noninvasively.
European journal of radiology 09/2011; 79(3):480-5. · 2.65 Impact Factor
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ABSTRACT: To investigate the image quality and dose performance of 80 kV high-pitch spiral (HPS) coronary CT angiography (CCTA). 106 patients consecutively enrolled into prospectively ECG-triggering HPS CCTA (pitch = 3.4) exam using kV/ref. mAs = 80/400, 100/370, and 120/370 when patient BMI was ≤22.5 (n = 40), between 22.5 and 27.5 (n = 53) and >27.5 kg/m² (n = 13). Image quality was assessed per-segment by two observers independently using a 4-point scale (1-excellent, 4-non-diagnosable). Image noise and signal-to-noise ratio (SNR), contrast-to-noise ratio were measured. Diagnostic image quality was obtained in 503 of 507, 687 of 693, 164 of 167 coronary segments in 80, 100, 120 kV groups without significant difference (P = 0.482). The proportions of segments with score 1-4 were not significantly different among three kV groups (all P > 0.05). Image noise were significantly higher in 80 kV group than 100 and 120 groups (P < 0.001), while SNR was not (P = 0.097). The effective dose of 80 kV group (0.36 ± 0.03 mSv) was significantly lower than that of 100 kV group (0.86 ± 0.08 mSv) and 120 kV group (1.77 ± 0.18 mSv). The mean ± SD of HR in all patients was 54.8 ± 5.1 bpm. 80 kV HPS CCTA is feasible for patient with BMI ≤ 22.5 kg/m² which can save 58% dose than 100 kV group, while maintain diagnosable image quality.
The international journal of cardiovascular imaging 05/2011; 28(2):415-23. · 2.15 Impact Factor
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Bin Lu,
Jin-Guo Lu,
Ming-Li Sun,
Zhi-Hui Hou,
Xiong-Biao Chen,
Xiang Tang, Run-Ze Wu,
Laura Johnson,
Shu-Bin Qiao,
Yue-Jin Yang,
Shi-Liang Jiang
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ABSTRACT: The purpose of this study was to evaluate and compare the diagnostic accuracy and radiation dose of dual-source computed tomographic (DSCT) coronary angiography for assessment of coronary artery disease using prospective electrocardiographic triggering and retrospective electrocardiographically (ECG) gated spiral scans. One hundred sixteen patients who had undergone dual-source computed tomography and conventional coronary angiography were enrolled in this study. Fifty-four patients were scanned using retrospective ECG-gated protocols (group 1) and 62 patients using prospective ECG-triggered protocols (group 2). Diagnostic accuracy, image quality, and effective dose were compared between groups 1 and 2. Conventional coronary angiography was used as the reference standard. In total 1,709 (98.2%) coronary segments in the 116 patients were assessable with adequate image quality. Sensitivities and specificities of diagnosing coronary heart disease (≥50% stenosis) in a patient-based analysis of DSCT data were 93.3% and 88.9% in group 1 and 96.4% and 85.7% in group 2, respectively (p=0.973 and 0.761). In vessel-based analysis, sensitivities and specificities were 77.4% and 94.1% in group 1 and 79.6% and 92.3% in group 2 (p=0.983 and 0.985). Overall averaged image quality scores (using 1- to 4-point scale) in groups 1 and 2 were 3.3 ± 0.4 and 3.5 ± 0.9, respectively (p=0.268). Prevalence of good (score 3.0) and excellent (score 4.0) image qualities of coronary vessels were 95.4% in group 1 and 92.4% in group 2 (p = 0.861). Effective doses were 8.82 ± 3.50 mSv (range 3.92 to 15.36) in group 1 and 2.95 ± 1.39 mSv (range 0.99 to 6.06) in group 2 (p<0.001). In conclusion, DSCT prospective ECG-triggered coronary angiography has equivalent image quality and diagnostic value compared to that of retrospective ECG-gated scans. Radiation dose was significantly decreased using prospective electrocardiographic triggering.
The American journal of cardiology 05/2011; 107(9):1278-84. · 3.58 Impact Factor
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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
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ABSTRACT: To evaluate the diagnostic accuracy of dual-source CT (DSCT) prospective ECG-triggering coronary angiography in patients with different heart rate (HR).
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.
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.
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.
European Radiology 04/2011; 21(8):1635-42. · 3.22 Impact Factor
