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320-detector CT coronary angiography with prospective and retrospective electrocardiogram gating in a single heartbeat: comparison of image quality and radiation dose

2012; Wiley; Volume: 85; Issue: 1015 Linguagem: Inglês

10.1259/bjr/29901700

1748-880X

Jian Qin, L. Liu, Yuan Fang, Zhu Jm, Ziyi Wu, Kangshun Zhu, Zhang Js, Hong Shan,

Advanced X-ray and CT Imaging

To compare the image quality, radiation dose and diagnostic accuracy of 320-detector CT coronary angiography with prospective and retrospective electrocardiogram (ECG) gating in a single heartbeat.Two independent reviewers separately scored image quality of coronary artery segment for 480 cardiac CT studies in a prospective group and a retrospective group (240 patients with a heart rate 0.05). The mean radiation dose was 10.0 ± 3.5 mSv (range 6.2-21.6 mSv) for prospective ECG gating at 65-85% of R-R interval (the interval between the R-wave of one heartbeat to the R-wave of the next). The mean radiation dose for retrospective ECG-triggered modulated scans was 23.2 ± 3.4 mSv (range 17-27.4 mSv). The mean radiation dose was 57% lower for prospective gating than for retrospective gating (p<0.01).Compared with coronary angiography, the results for prospective vs retrospective ECG gating were 92% vs 90% for sensitivity (p=0.23), 89% vs 91% for specificity (p=0.19), 90% vs 93% for positive predictive value (p=0.25) and 92% vs 95% for negative predictive value (p=0.21) for lesions with ≥50% stenosis, respectively.320-detector CT coronary angiography performed with prospective ECG gating has similar subjective image quality scores, but a 57% lower radiation dose than retrospective ECG gating in a single heartbeat.