The Feasibility of Combined Coronary and Supra-aortic Arteries CT Angiography with a Single High-pitch Acquisition Protocol using Dualsource CT

Abstract

Objectives: To compare the image quality and radiation dose of combined coronary and supra-aortic arteries CT angiography (CTA) with a one stop shop single high-pitch acquisition protocol to that of separately acquisition protocol. Materials and methods: This study screened 211 consecutively symptomatic patients who were suspected coronary artery disease and/or cerebrovascular diseases and a total of 164 patients were included in this study. Each group of 82 patients were randomly assigned in a 1:1 fashion to one of high-pitch combined coronary and supra-aortic arteries CTA acquisition protocol (group A) or separately acquisition protocol using high-pitch mode coronary CTA and Dual-energy mode carotid-cerebrovascular CTA (group B). The objective image quality including the enhancement values, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of coronary and supra-aortic arteries were measured and calculated. The subjective image quality was evaluated according to the image quality scores. Results: The average enhancement and image noise of supra-aortic arteries in group A were significantly higher than that of group B. The SNR and CNR measurements in the intra-cranial and extra-cranial carotid arteries did not show a statistically significant difference (all P>0.05). No significant difference was found for the mean image quality score either in coronary arteries or in the intra-cranial and extra-cranial carotid arteries between the two groups with regard to each score rate. The effective radiation dose was 1.36 ± 0.37 mSv in group A and 2.39 ± 0.38 mSv in group B (P<0.01). Conclusion: The results of our study indicate that the combined coronary and supra-aortic arteries CTA with a one stop shop single high-pitch acquisition protocol provides a high image quality and success ratio along with significant reduction of radiation exposure and less contrast material, compared to that of separately acquisition protocol.