Naslov
Koronarografija kompjutoriziranom tomografijom — tehnike snimanja i doze zračenja: rezultati Poliklinike SUNCE Split
(Coronary computed tomography angiography – acquisition techniques and radiation doses: results in SUNCE Polyclinic Split)

Autori
Medaković, Petar ; Jukić, Mladen ; Lukenda, Josip ; Pavić, Ladislav

Izvornik
Cardiologia croatica (1848-543X) 9 (2014), 9-10; 380-380

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
koronarografija kompjutoriziranim tomografijom, tehnike snimanja, doze zračenja
(coronary computed tomography angiography, acquisition techniques, radiation doses.)

Sažetak
Introduction: With 64 ≥ slice CT scanners, coronary computed tomography angiography (CCTA) has emerged as a useful diagnostic imaging modality for the assessment of coronary artery disease. It is considered appropriate for selected indications: A) patients with a low-tointermediate pretest probability for obstructive coronary artery disease (CAD) ; B) rapid evaluation of patients with chest pain in emergency ; C) by-pass analysis ; D) stent analysis. Aim: The aim is to present advantages of different CCTA techniques, dose reduction methods and to compare our results with the current literature. Materials and methods: During June 2011 and October 2014 we studied 215 consecutive patients with suspected CAD. CCTA was performed in all patient using a 64 slice CT scanner with two different (prospective and retrospective gatting) scanning protocols. Patients with heart rate (HR) >65 bpm were assigned for helical scanning (retrospective gatting) and patients with stable HR <65 bpm for step & shoot scanning (prospective gatting). Next inclusive parameter was specific clinical question or indication. Each patient with HR>65 bpm received beta-blockers two hours before the scan. Results: 215 CCTA were scanned: 186 step & shoot (prospective gatting) and 29 helical (retrospective gatting). The median value of radiation dose for step & shoot technique was 2, 5 mSv (0, 47 mSv-6, 44 mSv) and for helical: 4, 8 mSv (2, 1 mSv-7, 92 mSv). Conclusion: Applying different CCTA aquisition techniques helps to achieve maximal coronary dilatation and a low heart rate (<65 bpm). All benefits of the long diastolic phase are crucial to achieve the best possible image quality at the lowest patient radiation dose. Step & shoot aquisition technique is appropriate for patients with HR <65 bpm, younger, middle age patients and stent evaluation. Helical acquisition technique should be used in patients with HR >65bpm, elderly patients, if CT ventriculography is needed and analysis of coronary bridging (systolic and diastolic phase).

Izvorni jezik
Hrvatski, engleski

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