TY - JOUR
T1 - A comprehensive electrocardiogram-gated 64-slice multidetector computed tomography imaging protocol to visualize the coronary arteries, thoracic aorta, and pulmonary vasculature in a single breath hold
AU - Shapiro, Michael D.
AU - Dodd, Jonathan D.
AU - Kalva, Sanjeeva
AU - Wittram, Conrad
AU - Hsu, Joe
AU - Nasir, Khurram
AU - Liu, Bob
AU - Nagurney, John T.
AU - Kalra, Mannudeep K.
AU - Nichols, John H.
AU - Cury, Ricardo C.
AU - Abbara, Suhny
AU - Tawakol, Ahmed
AU - Brady, Thomas J.
AU - Hoffmann, Udo
PY - 2009
Y1 - 2009
N2 - OBJECTIVES: Advances in computed tomography technology may permit the evaluation of coronary disease, aortic dissection, and pulmonary embolism with a single contrast bolus and breath hold. We sought to determine whether 64-slice computed tomography angiography (CTA) allows for simultaneous visualization of the coronary arteries, thoracic aorta, and pulmonary arteries (coronary, aorta, pulmonary [CAP]) with image quality comparable to routine CTA protocols. MATERIALS AND METHODS: We prospectively enrolled 20 patients who underwent CAP CTA. Image quality of CAP CTA was assessed qualitatively and quantitatively and compared with dedicated coronary (n = 20) and pulmonary (n = 10) CTA data sets using matched controls. RESULTS: The mean amount of contrast and radiation dose was 132 ± 10 mL and 17.8 ± 1.8 mSv, 78 ± 9 mL and 13.7 ± 3.4 mSv, and 135 mL and 11.9 ± 1.5 mSv for CAP CTA, coronary CTA, and pulmonary CTA, respectively (P = 0.001). There was no difference in overall image quality (P = 0.88), presence of motion artifacts (P = 0.40), or enhancement of the proximal coronary arteries (median [interquartile range for contrast-noise ratio was 12.5 {9.9-15.2} vs 13.1 {10.3-16.9}; P = 0.17]) or thoracic aorta (264 [113-326] vs 245 [107-295]; P = 0.34) between CAP CTA and the dedicated coronary CTA, respectively. However, contrast attenuation was higher in the pulmonary arteries with CAP CTA (363 [253-424]) versus the standard pulmonary CTA protocol (235 [182-269]; P = 0.0001). CONCLUSIONS: Using an individually tailored single contrast injection, CAP CTA permits simultaneous visualization of the coronary arteries, thoracic aorta, and pulmonary arteries with excellent image quality. Further research is necessary to determine whether this protocol may enhance triage of patients with undifferentiated acute chest pain.
AB - OBJECTIVES: Advances in computed tomography technology may permit the evaluation of coronary disease, aortic dissection, and pulmonary embolism with a single contrast bolus and breath hold. We sought to determine whether 64-slice computed tomography angiography (CTA) allows for simultaneous visualization of the coronary arteries, thoracic aorta, and pulmonary arteries (coronary, aorta, pulmonary [CAP]) with image quality comparable to routine CTA protocols. MATERIALS AND METHODS: We prospectively enrolled 20 patients who underwent CAP CTA. Image quality of CAP CTA was assessed qualitatively and quantitatively and compared with dedicated coronary (n = 20) and pulmonary (n = 10) CTA data sets using matched controls. RESULTS: The mean amount of contrast and radiation dose was 132 ± 10 mL and 17.8 ± 1.8 mSv, 78 ± 9 mL and 13.7 ± 3.4 mSv, and 135 mL and 11.9 ± 1.5 mSv for CAP CTA, coronary CTA, and pulmonary CTA, respectively (P = 0.001). There was no difference in overall image quality (P = 0.88), presence of motion artifacts (P = 0.40), or enhancement of the proximal coronary arteries (median [interquartile range for contrast-noise ratio was 12.5 {9.9-15.2} vs 13.1 {10.3-16.9}; P = 0.17]) or thoracic aorta (264 [113-326] vs 245 [107-295]; P = 0.34) between CAP CTA and the dedicated coronary CTA, respectively. However, contrast attenuation was higher in the pulmonary arteries with CAP CTA (363 [253-424]) versus the standard pulmonary CTA protocol (235 [182-269]; P = 0.0001). CONCLUSIONS: Using an individually tailored single contrast injection, CAP CTA permits simultaneous visualization of the coronary arteries, thoracic aorta, and pulmonary arteries with excellent image quality. Further research is necessary to determine whether this protocol may enhance triage of patients with undifferentiated acute chest pain.
KW - Aortic dissection
KW - Computed tomography angiography
KW - Coronary artery disease
KW - Multidetector computed tomography
KW - Pulmonary embolism
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U2 - 10.1097/RCT.0b013e31817c12b1
DO - 10.1097/RCT.0b013e31817c12b1
M3 - Article
C2 - 19346850
AN - SCOPUS:64749100259
VL - 33
SP - 225
EP - 232
JO - Journal of Computer Assisted Tomography
JF - Journal of Computer Assisted Tomography
SN - 0363-8715
IS - 2
ER -