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CT angiography for planning transcatheter aortic valve replacement using automated tube voltage selection: Image quality and radiation exposure.

Abstract：

PURPOSE:To assess image quality and accuracy of CT angiography (CTA) for transcatheter aortic valve replacement (TAVR) planning performed with 3rd generation dual-source CT (DSCT). MATERIAL AND METHODS:We evaluated 125 patients who underwent TAVR-planning CTA on 3rd generation DSCT. A two-part protocol was performed including retrospectively ECG-gated coronary CTA (CCTA) and prospectively ECG-triggered aortoiliac CTA using 60mL of contrast medium. Automated tube voltage selection and advanced iterative reconstruction were applied. Effective dose (ED), signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were calculated. Five-point scales were used for subjective image quality analysis. In patients who underwent TAVR, sizing parameters were obtained. RESULTS:Image quality was rated good to excellent in 97.6% of CCTA and 100% of aortoiliac CTAs. CTA studies at >100kV showed decreased objective image quality compared to 70-100kV (SNR, all p≤0.0459; CNR, all p≤0.0462). Mean ED increased continuously from 70 to >100kV (CCTA: 4.5±1.7mSv-13.6±2.9mSv, all p≤0.0233; aortoiliac CTA: 2.4±0.9mSv-6.8±2.7mSv, all p≤0.0414). In 39 patients TAVR was performed and annulus diameter was within the recommended range in all patients. No severe cardiac or vascular complications were noted. CONCLUSION:3rd generation DSCT provides diagnostic image quality in TAVR-planning CTA and facilitates reliable assessment of TAVR device and delivery option while reducing radiation dose.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Mangold S,De Cecco CN,Schoepf UJ,Kuhlman TS,Varga-Szemes A,Caruso D,Duguay TM,Tesche C,Vogl TJ,Nikolaou K,Steinberg DH,Wichmann JL

doi

10.1016/j.ejrad.2016.11.023

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

276-283

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(16)30374-6

journal_volume

86

pub_type

杂志文章

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