Gender influence on dose saving allowed by prospective-triggered 64-slice multidetector computed tomography coronary angiography as compared with retrospective-gated mode

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• 作者：Antonio Esposito^a ; ^b ; ^{esposito.antonio@hsr.it} ; Francesco De Cobelli^a ; ^b ; Caterina Colantoni^a ; Gianluca Perseghin^c ; ^d ; Antonella del Vecchio^e ; Tamara Canu^a ; ^b ; Riccardo Calandrino^e ; Alessandro Del Maschio^a
• 关键词：Multi-detector-computed-tomography coronary angiography ; 64-slice MDCT ; Step-and-shoot ; Coronary artery disease ; Radiation dose ; Dose saving
• 刊名：International Journal of Cardiology
• 出版年：2012
• 期刊代码：128_01675273
• 类别：med
• 出版时间：12 July, 2012
• 卷：158
• 期：2
• 页码：253-259
• 文件大小：356 K

摘要

Background/objectives

To assess the gender influence on radiation dose saving allowed by prospective ECG-triggered MDCT coronary angiography (P-MDCT-CA) in comparison with retrospective ECG-gated MDCT-CA (R-MDCT-CA).

The influence of kilovoltage and body mass index on radiation dose and the impact of different parameters on image quality (IQ) and diagnostic confidence (DC), were also determined.

Methods

64-slice MDCT-CA was performed in 176 patients: 66 R-MDCT-CA and 110 P-MDCT-CA.

Effective dose was determined using ImpactDose software based on Monte Carlo method.

Three point scales were used to assess IQ and DC on a segmental basis.

Results

Patients were divided into 4 groups according with the examination performed: group A (90 pts, coronary tree assessment with P-MDCT-CA); group B (55 pts, coronary tree assessment with R-MDCT-CA); group C (20 pts, bypass grafts assessment with P-MDCT-CA); and group D (11 pts, bypass grafts assessment with R-MDCT-CA).

Effective dose was 68%lower for P-MDCT-CA than R-MDCT-CA for coronary artery studies (Gr. A = 4.7 卤 1.69 mSv and Gr. B = 14.9 卤 4.4 mSv; p < 0.05) and 63%lower for by-pass studies. Effective dose resulted significantly higher in women than in men who underwent R-MDCT-CA; conversely, no gender impact was observed on effective dose of P-MDCT-CA. As a result, dose saving with prospective gating was more pronounced in women (73%; R-MDCT-CA:16.3 mSv, P-MDCT-CA:4.5 mSv,) than in men (60%; R-MDCT-CA:12.8 mSv, P-MDCT-CA:4.8 mSv). IQ and DC of P-MDCT-CA were better or comparable than R-MDCT-CA

Conclusions

P-MDCT-CA provides at least comparable IQ and DC than R-MDCT-CA with significant dose saving. This study highlights the important advantage offered by using P-MDCT-CA in female patients.