Diagnostic performance of two types of low radiation exposure protocol for prospective ECG-triggering multidetector computed tomography angiography in assessment of coronary artery bypass graft

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• 作者：Daniele Andreini ; ^{daniele.andreini@ccfm.it} ; Gianluca Pontone ; Saima Mushtaq ; Andrea Annoni ; Alberto Formenti ; Erika Bertella ; Alessandro Parolari ; Piergiuseppe Agostoni ; Antonio Bartorelli ; Giovanni Ballerini ; Cesare Fiorentini ; Mauro Pepi
• 关键词：Coronary artery bypass graft ; Multidetector computed tomography ; Radiation dose exposure
• 刊名：International Journal of Cardiology
• 出版年：2012
• 期刊代码：128_01675273
• 类别：med
• 出版时间：17 May, 2012
• 卷：157
• 期：1
• 页码：63-69
• 文件大小：693 K

摘要

Background

Multidetector computed tomography (MDCT) is useful in evaluation of coronary artery bypass graft (CABG). However, radiation exposure is a reason for concern. We compared diagnostic performance and effective dose of a new dedicated post-processing reconstruction algorithm with BMI-adapted scanning protocol (MDCT-XTe) vs. standard prospective ECG-triggering protocol (MDCT-XT) and retrospective ECG-triggering (MDCT-Helical), compared to invasive coronary angiography (ICA), in the assessment of grafts and nongrafted or distal runoff coronary arteries.

Methods

One hundred and nineteen patients with 277 grafts were randomized to Group 1 based on BMI-adapted scanning protocol with prospective ECG-triggering (40 patients), Group 2 with prospective ECG-triggering (39 patients) and Group 3 (40 patients) with retrospective ECG-triggering. Data were acquired using 64-slice MDCT.

Results

MDCT correctly assessed the patency of all CABG in 3 groups. After comparison with ICA, MDCT was able to correctly detect the occlusion or stenosis of CABG in all groups, with the exception of one case of Group 3. In Group 3 sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CABG evaluation were 100%, 98.4%, 96.7%, 100%and 98.9%, respectively. In Groups 1 and 2 the diagnostic accuracy of CABG evaluation was 100%. Effective radiation dose was 3.5 卤 1.4 mSv in Group 1 vs. 7.4 卤 2.6 mSv in Group 2 vs. 27.8 卤 9.4 mSv in Group 3.

Conclusions

Our results indicated that MDCT-XTe and MDCT-XT have a diagnostic performance in the evaluation of CABG similar to MDCT-Helical, with a significant reduction of radiation exposure, specially for MDCT-XTe.