Publikation
Prospective and retrospective ECG-gating for CT coronary angiography perform similarly accurate at low heart rates
Wissenschaftlicher Artikel/Review - 14.01.2010
Stolzmann Paul, Alkadhi Hatem, Marincek Borut, Feuchtner Gudrun, Scheffel Hans, Falk Volkmar, Plass André, Baumueller Stephan, Goetti Robert, Leschka Sebastian
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OBJECTIVE: To compare, in patients with suspicion of coronary artery disease (CAD) and low heart rates, image quality, diagnostic performance, and radiation dose values of prospectively and retrospectively electrocardiography (ECG)-gated dual-source computed tomography coronary angiography (CTCA) for the diagnosis of significant coronary stenoses. MATERIALS AND METHODS: Two-hundred consecutive patients with heart rates 0.05). There was no significant difference in the rate of non-assessable coronary segments between group 1 (1.6%, 24/1404) and group 2 (1.4%, 19/1385; p=0.77); non-diagnostic image quality was significantly (p<0.001) more often attributed to stair step artifacts in group 1. Segment-based sensitivity, specificity, PPV, NPV, and accuracy were 98%, 98%, 88%, 100%, and 100% among group 1; 96%, 99%, 90%, 100%, and 98% among group 2, respectively. Parameters of diagnostic performance were similar (all p>0.05). Mean effective radiation dose of prospectively ECG-gated CTCA (2.2+/-0.4mSv) was significantly (p<0.0001) smaller than that of retrospectively ECG-gated CTCA (8.1+/-0.6mSv). CONCLUSION: Prospectively ECG-gated CTCA yields similar image quality, performs as accurately as retrospectively ECG-gated CTCA in patients having heart rates