Modified Subtraction Coronary CT Angiography Method for Patients Unable to Perform Long Breath-Holds
| Autor: | Tsuyoshi Sugawara, Kyouhei Nagata, Kei Kikuchi, Kunihiro Yoshioka, Akinobu Sasaki, Takuya Chiba, Tadashi Sasaki, Yuta Ueyama, Ryoichi Tanaka, Takanori Ueda, Kouta Takeda |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test Image quality business.industry digestive oral and skin physiology Subtraction Coronary ct angiography 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging Coronary Calcium Score Coronary arteries 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Radiology Nuclear Medicine and imaging Hounsfield scale Angiography medicine Radiology Nuclear Medicine and imaging Radiology Nuclear medicine business Computed tomography angiography |
| Zdroj: | Academic Radiology. 23:1170-1175 |
| ISSN: | 1076-6332 |
| DOI: | 10.1016/j.acra.2016.04.012 |
| Popis: | Rationale and Objectives Severe calcifications of the coronary arteries are still a major challenge in coronary computed tomography (CT) angiography (CCTA). Subtraction CCTA using a 320-detector row CT scanner has recently been introduced for patients with severe calcifications. However, the conventional subtraction CCTA method requires a long breath-holding time of approximately 20–40 seconds. This is a major problem in clinical practice because many patients may not be able to perform such a long breath-hold. We explored a modified subtraction CCTA method with a short breath-holding time to overcome this problem. Materials and Methods This study was approved by our institutional review board, and all patients gave written informed consent. A total of 12 patients with a coronary calcium score of >400 were enrolled in this study. All patients were unable to hold their breath for more than 20 seconds. Modified subtraction CCTA was performed using the bolus-tracking method. The acquisition protocol was adjusted so that the mask scan was acquired 10 seconds after the postcontrast scan during a single breath-hold. The subtraction image was obtained by subtracting the mask image data from the postcontrast image data. The breath-holding times were recorded. Enhancement of the coronary arteries in the subtraction images was assessed. Subjective image quality was evaluated in a total of 32 segments using a 4-point scale. Results The mean breath-holding time was 12.8 ± 0.8 seconds (range, 12–14 seconds). The average CT number in the coronary arteries was 288.6 ± 80.5 Hounsfield units (HU) in the subtraction images. Average image quality was significantly increased from 2.1 ± 0.9 with conventional CCTA to 3.1 ± 0.7 with subtraction CCTA ( P P = 0.001). Conclusions This preliminary study has shown that our modified subtraction CCTA method allows the breath-holding time to be shortened to |
| Databáze: | OpenAIRE |
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