Vincenzo Russo1, Monica Garattoni2, Francesco Buia2, Domenico Attinà2, Luigi Lovato2, Maurizio Zompatori2. 1. Cardio-Thoracic-Vascular Department, Cardio-Thoracic Radiology Unit, University Hospital "S.Orsola", Via Massarenti 9, Bologna, Italy. vi-rus@fastwebnet.it. 2. Cardio-Thoracic-Vascular Department, Cardio-Thoracic Radiology Unit, University Hospital "S.Orsola", Via Massarenti 9, Bologna, Italy.
Abstract
OBJECTIVE: To evaluate image quality and radiation dose of non ECG-gated 128-slice CT angiography of the aorta (CTAA) with fast gantry rotation time and iterative reconstruction. METHODS: Four hundred and eighty patients underwent non ECG-gated CTAA. Qualitative and quantitative image quality assessments were performed. Radiation dose was assessed and compared with the dose of patients who underwent ECG-gated CTAA (n = 126) and the dose of previous CTAA performed with another CT (n = 339). RESULTS: Image quality (aortic root-ascending portion) was average-to-excellent in more than 94% of cases, without any non-diagnostic scan. For proximal coronaries, image quality was average-to-excellent in more than 50%, with only 21.5% of non-diagnostic cases. Quantitative analysis results were also good. Mean radiation dose for thoracic CTAA was 5.6 mSv versus 20.6 mSv of ECG-gated protocol and 20.6 mSv of 16-slice CTAA scans, with an average dose reduction of 72.8% (p < 0.001). Mean radiation dose for thoracic-abdominal CTAA was 9.7 mSv, versus 20.9 mSv of 16-slice CTAA scans, with an average dose reduction of 53.6% (p < 0.001). CONCLUSIONS: Non ECG-gated 128-slice CTAA is feasible and able to provide high quality visualization of the entire aorta without significant motion artefacts, together with a considerable dose and contrast media volume reduction. KEY POINTS: • CT image quality of aortic root-ascending aorta is challenging. • Non ECG-gated scans are often limited by pulsatility artefacts. • ECG-gated examinations are usually limited by high radiation doses. • Non ECG-gated 128-slice low dose CTAA provides high quality images. • 128-slice CTAA low dose protocol could frequently replace ECG-gated CTAA.
OBJECTIVE: To evaluate image quality and radiation dose of non ECG-gated 128-slice CT angiography of the aorta (CTAA) with fast gantry rotation time and iterative reconstruction. METHODS: Four hundred and eighty patients underwent non ECG-gated CTAA. Qualitative and quantitative image quality assessments were performed. Radiation dose was assessed and compared with the dose of patients who underwent ECG-gated CTAA (n = 126) and the dose of previous CTAA performed with another CT (n = 339). RESULTS: Image quality (aortic root-ascending portion) was average-to-excellent in more than 94% of cases, without any non-diagnostic scan. For proximal coronaries, image quality was average-to-excellent in more than 50%, with only 21.5% of non-diagnostic cases. Quantitative analysis results were also good. Mean radiation dose for thoracic CTAA was 5.6 mSv versus 20.6 mSv of ECG-gated protocol and 20.6 mSv of 16-slice CTAA scans, with an average dose reduction of 72.8% (p < 0.001). Mean radiation dose for thoracic-abdominal CTAA was 9.7 mSv, versus 20.9 mSv of 16-slice CTAA scans, with an average dose reduction of 53.6% (p < 0.001). CONCLUSIONS: Non ECG-gated 128-slice CTAA is feasible and able to provide high quality visualization of the entire aorta without significant motion artefacts, together with a considerable dose and contrast media volume reduction. KEY POINTS: • CT image quality of aortic root-ascending aorta is challenging. • Non ECG-gated scans are often limited by pulsatility artefacts. • ECG-gated examinations are usually limited by high radiation doses. • Non ECG-gated 128-slice low dose CTAA provides high quality images. • 128-slice CTAA low dose protocol could frequently replace ECG-gated CTAA.
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