Feasibility of low-dose contrast medium high pitch CT angiography for the combined evaluation of coronary, head and neck arteries

• Published in: PloS one 2014-03, Vol.9 (3), p.e90268
• Main Authors: Wang, Zhiwei, Chen, Yu, Wang, Yining, Xue, Huadan, Jin, Zhengyu, Kong, Lingyan, Cao, Jian, Li, Shuo
• Format: Article
• Language: English
• Subjects: Angiography; Angiography - methods; Aorta; Arteries; Atherosclerosis; Biology; Body mass; Cardiovascular disease; Carotid arteries; Carotid artery; CAT scans; Comparative analysis; Computed tomography; Contrast agents; Contrast Media - administration & dosage; Coronary artery; Coronary vessels; Coronary Vessels - diagnostic imaging; Diagnostic systems; Dose-Response Relationship, Drug; Echocardiography; EKG; Electrocardiography; Evaluation; Feasibility Studies; Head - blood supply; Head and neck; Heart; Heart rate; Hospitals; Humans; Image processing; Image quality; Intravenous administration; Medical imaging; Medicine; Neck; Neck - blood supply; Patients; Quality; Radiation; Radiation (Physics); Radiation dosage; Scanning; Sensors; Tomography; Tomography, X-Ray Computed
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0090268

To evaluate the image quality and radiation dose of combined heart, head, and neck CT angiography (CTA) using prospectively electrocardiography (ECG)-triggered high-pitch spiral scan protocol, compared with single coronary CTA. 151 consecutive patients were prospectively included and randomly divided into three groups. Group 1 (n = 47) underwent combined heart, neck, and head CTA using prospectively ECG-triggered high-pitch spiral (Flash) scan protocol with a single-phase intravenous injection of iodinated contrast and saline flush; Group 2 (n = 51) underwent single coronary CTA with Flash scan protocol; and Group 3 (n = 53) underwent single coronary CTA with prospective sequence scan protocol. All patients were examined on a dual source CT (Definition FLASH). The image quality was determined for each CT study. Patients of scanning protocol Group 1, 2, and 3 showed no significant differences in age, sex, heart rates, and BMI. Evaluation of coronary artery image quality showed comparable results in the three scanning protocol groups on a per patient-based analysis. In group 1, image quality was found to be sufficient to be diagnostic in all arterial segments of carotid arteries. The mean dose-length product (DLP) for group 1 was 256.3±24.5 mGy×cm and was significantly higher in comparison with group 2 (93.4±19.9 mGy×cm; p < 0.001). However, there was no significant difference of DLP between group 1 and group 3 (254.1±69.9 mGy×cm). The combined heart, neck, and head arteries scan using prospectively electrocardiography (ECG)-triggered high-pitch spiral scan protocol in 1 single examination resulted in an excellent opacification of the aorta, the carotid arteries, and the coronary arteries and provided a good image quality with low radiation dose.