“Ultrafast” Multispiral Computer Tomographic Angiography of Aorta: Current Reality and Perspectives
https://doi.org/10.24835/1607-0763-2017-4-33-40
Abstract
Objective: to carried out the comparison of the data of MDCT of the patients, undergoing screening using the standard protocol MDCT aortography and FLASH “fast” protocol of scanning. It is discussed the possibility of the reduction of the injected amount of the contrast agent for “fast” aortography.
Materials and methods. The aorta examinations of 101 patients (69 men (68%) and 32 women (32%); the average age ± the standard deviation – 56.34 ± 11.5 years) were analyzed. The examinations have been carried out on MDCT with two sources of Х-ray (DSCT); 48 patients have been undergone the examination using “fast” FLASH scanning. It has been compared the scanning time, the length of the examination zone and ED (Effective Dose) load calculated for the groups for the standard and “fast” MDCT aortography.
Results. CDTIvol and DLP values were statistically proved lower (p < 0.001) at the examination of the patients that had been undergone “fast” protocol of scanning FLASH. The average ED was considerably lower in this group of the patients in comparison with the patients that had been examined using standard protocol (4.36 ± 1.69 mSv and 15.12 ± 4.62 mSv, р < 0.001). Without the reliable difference in the length of the examination zone in groups (42.91 ± 3.23 cm and 43.68 ± 2.66 cm, p = 0.55), the duration of the examination of MDCT aorta was considerably lower in the second group (9.29 ± 0.85s and 1.93 ± 0.12 s, p < 0.001).
Conclusion. The method of the superfast aorta МDCT make it possible to reduce ED and the amount of the injected contrast agent at the examination of the vast zone. At the same time, qualitative and quantitative analysis of the MDCT remains high.
About the Authors
V. V. Khovrin
B.V. Petrovsky Russian National Center of Surgery
Russian Federation
Competing Interests:
Russian Federation
Competing Interests:
doct. of med. sci., head of XRay and CT diagnostic department of Petrovsky National Research Center of Surgery, Moscow
Abrikosovsky 2, Moscow, Russia, 119991, B.V. Petrovsky Russian National Center of Surgery. Phone: 8-916-646-90-23
T. N. Galyan
B.V. Petrovsky Russian National Center of Surgery
Russian Federation
Competing Interests: cand. of med. sci., the senior research of XRay and CT diagnostic department of Petrovsky National Research Center of Surgery
Russian Federation
Competing Interests: cand. of med. sci., the senior research of XRay and CT diagnostic department of Petrovsky National Research Center of Surgery
M. V. Malakhova
B.V. Petrovsky Russian National Center of Surgery
Russian Federation
Competing Interests: doctor of of XRay and CT diagnostic department of Petrovsky National Research Center of Surgery, Moscow
Russian Federation
Competing Interests: doctor of of XRay and CT diagnostic department of Petrovsky National Research Center of Surgery, Moscow
Z. R. Khachatrian
B.V. Petrovsky Russian National Center of Surgery
Russian Federation
Competing Interests:
Russian Federation
Competing Interests:
graduate student, cardiovascular surgeon of surgery of an aorta and its branches department of Petrovsky Russian Research Center of Surgery, Moscow
E. R. Charchian
B.V. Petrovsky Russian National Center of Surgery
Russian Federation
Competing Interests:
Russian Federation
Competing Interests:
Corresponding-member of RAS, professor, chief of aortic surgery department of Petrovsky Russian Research Center of Surgery, Moscow
References
1. Petersilka M., Bruder H., Krauss B., Stierstorfer K., Flohr T.G. Technical principles of dual source CT. Eur. J. Radiol. 2008; 68: 362–368. DOI: 10.1016/j.ejrad.2008.08.013.
2. Rubin G.D., Leipsic J., Schoepf J., Fleischmann D., Napel S. CT Angiography after 20 Years: A Transformation in Cardiovascular Disease Characterization Continues to Advance. Radiology. 2014; 271: 633–652. DOI: 10.1148/radiol.14132232.
3. Karmazanovsky G.G. Current approaches to optimize the administration of contrast media. Medical Visualization. 2006; 5: 136–141. (In Russian)
4. Fleischmann D. Contrast medium administration in computed tomographic angiography. In: Rubin G.D., Rofsky N.M. CT and MR angiography: comprehensive vascular assessment. Philadelphia, Pa: Lippincott Williams & Wilkins, 2009: 129–154.
5. Prokop M. Multislice CT angiography. Eur. J. Radiol. 2000; 36: 86–96. PMID: 11116172.
6. Minqiang Xin, Lanhua Mu, Jie Luan, Dali Mu, Jinguo Lu. The value of multidetector-row CT angiography for preoperative planning of breast reconstruction with deep inferior epigastric arterial perforator flaps. Br. J. Radiol. 2010; 83: 40–43. DOI: 10.1259/bjr/29140440.
7. Smith A., Schoenhagen P. CT imaging for acute aortic syndrome. Cleveland Clin. J. Med. 2008; 75 (1): 7–24. PMID: 18236724.
8. Williams D.M., Cronin P., Dasika N., Kelly A.M., Upchurch G.R. Jr., Patel H.J., Deeb M.G., Nan B., Zheng J. Aortic branch artery pseudoaneurysms accompanying aortic dissection. Part II. Distinction from penetrating atherosclerotic ulcers. J. Vasc. Interv. Radiol. 2006; 17 (5): 773–781. DOI: 10.1097/01.RVI.0000209345.00529.DF.
9. Talen M., Erbel R., Krejter K.-F., Barkhauzen J. Methods of diagnosing heart disease. Trans. germ. (Ed. prof. V.E. Sinitsin). M.: MEDpress-inform, 2011. 408 c. (In Russian)
10. Khovrin V.V., Galyan T.N., Dikovitskaya N.A. Endovascular treatment of aneurysms of the abdominal aorta. Basic principles of optimal choice. Medical Visualization. 2008; 6: 99–106. (In Russian)
11. Moon M.C., Greenberg R.K., Morales J.P., Martin Z., Lu Q., Dowdall J.F., Hermandez A.V. Computed tomographybased anatomic characterization of proximal aortic dissection with consideration for endovascular candidacy. J. Vasc. Surg. 2011; 53: 942–949. DOI: 10.1016/j.jvs.2010.10.067.
12. Charchyan E.R., Abugov S.A., Skvorcov A.A., Khovrin V.V., Fedulova S.V. Hybrid technology in the reoperation of a patient with an aortic arch aneurysm and type A chronic dissection. Angiologiya i sosudistaya hirurgiya. 2014; 20 (4): 168–173. (In Russian)
13. Tacelli N., Remy-Jardin M., Flohr T., Faivre J.B., Delannoy V., Duhamel A., Remy J. Dual-source chest CT angiography with high temporal resolution and high pitch modes: evaluation of image quality in 140 patients. Eur. Radiol. 2010; 20: 1188– 1196. DOI: 10.1007/s00330-009-1638-5.
14. Halliburton S.S., Abbara S., Chen M.Y., Gentry R., Mahesh M., Raff G.L., Shaw L.J., Hausleiter J.; Society of Cardiovascular Computed Tomography. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J. Cardiovasc. Comput. Tomogr. 2011; 5: 198–224. DOI: 10.1016/j.jcct.2011.06.001.
15. Menzel H.G., O’Sullivan D., Beck P., Bartlett D. European measurements of aircraft crew exposure to cosmic radiation. Health. Phys. 2000; 79: 563–567.
16. Macari M., Chandarana H., Schmidt B., Lee J., lamparello P., Babb J. Abdominal aortic aneurysm: can the arterial phase at CT evaluation after endovascular repair be eliminated to reduce radiation dose? Radiology. 2006; 241: 908–914. DOI: 10.1148/radiol.2413051571.
17. Goetti R., Baumuller S., Feuchtner G., Stolzmann P., Karlo C., Alkadhi H., Leschka S. High-pitch dual-source CT angiography of the thoracic and abdominal aorta: is simultaneous coronary artery assessment possible? Am. J. Roentgenol. 2010; 194: 938–944. DOI: 10.1007/s00330-010-1838-z.
18. Halliburton S.S., Sola S., Kuzmiak S.A., Obuchowski N.A., Desai M., Flamm S.D., Schoenhagen P. Effect of dualsource cardiac computed tomography on patient radiation dose in a clinical setting: comparison to singlesource imaging. J. Cardiovasc. Comput. Tomogr. 2008; 2: 392–400.
19. Apfaltrer P.,Hanna E.L., Schoepf U.J., Spears J.R., Schoenberg S.O., Fink C., Vliegenthart R. Radiation Dose and Image Quality at High-Pitch CT Angiography of the Aorta: intraindividual and interindividual comparisons with conventional CT Angiography. Am. J. Roentgenol. 2012; 199 (6): 1402–1409. DOI: 10.2214/AJR.12.8652.
20. Cornfeld D., Israel G., Detroy E., Bokhari J., Mojibian H. Impact of adaptive statistical iterative reconstruction (ASIR) on radiation dose and image quality in aortic dissection studies: a qualitative and quantitative analysis. Am. J. Roentgenol. 2011; 196: 713; W336–340. DOI: 10.2214/AJR.10.4573.
21. Schoenhagen P., Bolen M.A., Halliburton S.S. Iterative CT reconstruction of aortic intramural hematoma. Circulation J. 2011; 75 (7): 1774–1776. DOI: 10.1253/circj.CJ-10-1250.
22. Karlo C., Leschka S., Goetti R.P., Feuchtner G., Desbiolles L., Stolzmann P., Plass A., Falk V., Marincek B., Alkadhi H., Baumuller S. High-pitch dual-source CT angiography of the aortic valve–aortic root complex without ECG-synchronization. Eur. Radiol. 2011; 21: 205–212. DOI: 10.1007/s00330-010-1907-3.
23. Beeres M., Schell B., Mastragelopoulos A., Hermann E., Kerl J.M., Gruber-Rouh T., Lee C., Siebenhandle P., Bodelle B., Zangos S., Vogl T.J., Jacobi V., Bauer R.W. High-pitch dual-source CT angiography of the whole aorta without ECG synchronisation: initial experience. Eur. Radiol. 2012; 22: 129–137. https://doi.org/10.1007/s00330-011-2257-5.
24. Bolen M.A., Popovic Z.B., Tandon N., Flamm S.D., Schoenhagen P., Halliburton S.S. Image quality, contrast enhancement, and radiation dose of ECG-triggered highpitch CT versus non ECG-triggered standard-pitch CT of the thoracoabdominal aorta. Am. J. Roentgenol. 2012; 198: 931–938. DOI: 10.2214/AJR.11.6921.
25. Sahani D., Saini S., D’Souza R.V., O’Neill M.J., Prasad S.R., Karla M.K., Halpern E.F., Mueller P. Comparison between low (3:1) and high (6:1) pitch for routine abdominal/pelvic imaging with multislice computed tomo graphy. J. Comput. Assist. Tomogr. 2003; 27: 105–109. https://doi.org/10.1097/00004728-200303000-00001.
26. Mileto A., Ramirez-Giraldo J.K., Lynne M., Hurwitz L., Choudhury R., Danielle M., Seaman D., Daniele Marin D. High-Pitch Dual-Source MDCT for Imaging of the Thoracoabdominal Aorta: Relationships Among Radiation Dose, Noise, Pitch, and Body Size in a Phantom Experiment and Clinical Study. Am. J. Roentgenol. 2015; 205: 834–839. https://doi.org/10.2214/AJR.15.14334.
27. Pulerwitz T., Khalique O.K., Nazif T.N., Rozenshtein A., Pearson G.D., Hahn R. T., Vahl T.P., Kodali S.K., George I., Leon M.B., D'Souza B., Po M.J., Einstein A.J. Very Low Intravenous Contrast Volume Protocol for Computed Tomography Angiography Providing Comprehensive Cardiac and Vascular Assessment Prior to Transcatheter Aortic Valve Replacement in Patients with Chronic Kidney Disease. J. Cardiovasc. Comput. Tomogr. 2016; 10 (4): 316–321. DOI:10.1016/j.jcct.2016.03.005.
Review
For citations:
Khovrin V.V., Galyan T.N., Malakhova M.V., Khachatrian Z.R., Charchian E.R. “Ultrafast” Multispiral Computer Tomographic Angiography of Aorta: Current Reality and Perspectives. Medical Visualization. 2017;(4):33-40. (In Russ.) https://doi.org/10.24835/1607-0763-2017-4-33-40
Views:
1735
Email this article 