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Preliminary study of prospective ECG-gated 320-detector CT coronary angiography in patients with ventricular premature beats.

Zhang T, Bai J, Wang W, Wang D, Shen B - PLoS ONE (2012)

Bottom Line: In the control group these values were found to be 95.79%, 98.42%, 90.11%, and 99.28% respectively.The two groups had no significant difference in image quality score (P>0.05).For patients with slow heart rates and good rhythm, there was no statistically significant difference in image quality.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, China.

ABSTRACT

Background: To study the applicability of prospective ECG-gated 320-detector CT coronary angiography (CTCA) in patients with ventricular premature beats (VPB), and determine the scanning mode that best maximizes image quality and reduces radiation dose.

Methods: 110 patients were divided into a VPB group (60 cases) and a control group (50 cases) using CTCA. All the patients then underwent coronary angiography (CAG) within one month. CAG served as a reference standard through which the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CTCA in diagnosing significant coronary artery stenosis (luminal stenosis ≥50%) could be analyzed. The two radiologists with more than 3 years' experience in cardiac CT each finished the image analysis after consultation. A personalized scanning mode was adopted to compare image quality and radiation dose between the two groups.

Methodology/principal findings: At the coronary artery segment level, sensitivity, specificity, PPV, and NPV in the premature beat group were 92.55%, 98.21%, 88.51%, and 98.72% respectively. In the control group these values were found to be 95.79%, 98.42%, 90.11%, and 99.28% respectively. Between the two groups, specificity, sensitivity PPV, NPV was no significant difference. The two groups had no significant difference in image quality score (P>0.05). Heart rate (77.20±12.07 bpm) and radiation dose (14.62±1.37 mSv) in the premature beat group were higher than heart rate (58.72±4.73 bpm) and radiation dose (3.08±2.35 mSv) in the control group. In theVPB group, the radiation dose (34.55±7.12 mSv) for S-field scanning was significantly higher than the radiation dose (15.10±1.12 mSv) for M-field scanning.

Conclusions/significance: With prospective ECG-gated scanning for VPB, the diagnostic accuracy of coronary artery stenosis is very high. Scanning field adjustment can reduce radiation dose while maintaining good image quality. For patients with slow heart rates and good rhythm, there was no statistically significant difference in image quality.

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Related in: MedlinePlus

Axial A-D of middle segment of the RCA are respectively scored as 4–1:4, excellent, no artifacts; 3, good, mild artifacts; 2, acceptable, moderate artifacts, but can still make a diagnosis; and 1, cannot evaluate, severe artifacts, cannot make a diagnosis.
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pone-0038430-g001: Axial A-D of middle segment of the RCA are respectively scored as 4–1:4, excellent, no artifacts; 3, good, mild artifacts; 2, acceptable, moderate artifacts, but can still make a diagnosis; and 1, cannot evaluate, severe artifacts, cannot make a diagnosis.

Mentions: According to the classification criteria issued by the American Heart Association (AHA), the coronary artery is divided into 15 segments [11]. CTCA image quality is divided into four grades: 4, excellent, no artifacts; 3, good, mild artifacts; 2, acceptable, moderate artifacts, but a diagnosis is still possible; and 1, cannot evaluate, severe artifacts, a diagnosis is not possible (Figure 1). All 15 segments of the coronary artery with a luminal diameter ≥1.5 mm were scored. Two reviewers (with more than 3 years’ experience in cardiac CT each) who were blinded to the CT protocol and the results of CCA independently assessed the reconstructed images. After their separate reading sessions, the discrepancy was resolved during a third session, in which the reviewers read images together at the same time to reach a consensus.


Preliminary study of prospective ECG-gated 320-detector CT coronary angiography in patients with ventricular premature beats.

Zhang T, Bai J, Wang W, Wang D, Shen B - PLoS ONE (2012)

Axial A-D of middle segment of the RCA are respectively scored as 4–1:4, excellent, no artifacts; 3, good, mild artifacts; 2, acceptable, moderate artifacts, but can still make a diagnosis; and 1, cannot evaluate, severe artifacts, cannot make a diagnosis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3368870&req=5

pone-0038430-g001: Axial A-D of middle segment of the RCA are respectively scored as 4–1:4, excellent, no artifacts; 3, good, mild artifacts; 2, acceptable, moderate artifacts, but can still make a diagnosis; and 1, cannot evaluate, severe artifacts, cannot make a diagnosis.
Mentions: According to the classification criteria issued by the American Heart Association (AHA), the coronary artery is divided into 15 segments [11]. CTCA image quality is divided into four grades: 4, excellent, no artifacts; 3, good, mild artifacts; 2, acceptable, moderate artifacts, but a diagnosis is still possible; and 1, cannot evaluate, severe artifacts, a diagnosis is not possible (Figure 1). All 15 segments of the coronary artery with a luminal diameter ≥1.5 mm were scored. Two reviewers (with more than 3 years’ experience in cardiac CT each) who were blinded to the CT protocol and the results of CCA independently assessed the reconstructed images. After their separate reading sessions, the discrepancy was resolved during a third session, in which the reviewers read images together at the same time to reach a consensus.

Bottom Line: In the control group these values were found to be 95.79%, 98.42%, 90.11%, and 99.28% respectively.The two groups had no significant difference in image quality score (P>0.05).For patients with slow heart rates and good rhythm, there was no statistically significant difference in image quality.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, China.

ABSTRACT

Background: To study the applicability of prospective ECG-gated 320-detector CT coronary angiography (CTCA) in patients with ventricular premature beats (VPB), and determine the scanning mode that best maximizes image quality and reduces radiation dose.

Methods: 110 patients were divided into a VPB group (60 cases) and a control group (50 cases) using CTCA. All the patients then underwent coronary angiography (CAG) within one month. CAG served as a reference standard through which the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CTCA in diagnosing significant coronary artery stenosis (luminal stenosis ≥50%) could be analyzed. The two radiologists with more than 3 years' experience in cardiac CT each finished the image analysis after consultation. A personalized scanning mode was adopted to compare image quality and radiation dose between the two groups.

Methodology/principal findings: At the coronary artery segment level, sensitivity, specificity, PPV, and NPV in the premature beat group were 92.55%, 98.21%, 88.51%, and 98.72% respectively. In the control group these values were found to be 95.79%, 98.42%, 90.11%, and 99.28% respectively. Between the two groups, specificity, sensitivity PPV, NPV was no significant difference. The two groups had no significant difference in image quality score (P>0.05). Heart rate (77.20±12.07 bpm) and radiation dose (14.62±1.37 mSv) in the premature beat group were higher than heart rate (58.72±4.73 bpm) and radiation dose (3.08±2.35 mSv) in the control group. In theVPB group, the radiation dose (34.55±7.12 mSv) for S-field scanning was significantly higher than the radiation dose (15.10±1.12 mSv) for M-field scanning.

Conclusions/significance: With prospective ECG-gated scanning for VPB, the diagnostic accuracy of coronary artery stenosis is very high. Scanning field adjustment can reduce radiation dose while maintaining good image quality. For patients with slow heart rates and good rhythm, there was no statistically significant difference in image quality.

Show MeSH
Related in: MedlinePlus