320列面検出器CTを用いた前向き心電図同期冠動脈撮影の 心拍数別撮影プロトコルにおける被ばくと画質の検討
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The purpose of this study is to estimate radiation dose and image quality of ECG-gated coronary 320-area detector CT (ADCT) angiography which was acquired using the protocols that were considered as optimal methods for different heart rates (HR) in 1031 consecutive patients (M/F=580/451, 65±12 yr) without arrhythmias. We set up 5 protocols for 320-ADCT based on the relationship among heart rates, temporal resolution, gantry rotation speed, optimal reconstruction phase and slow filling phase on 64-multidetector-row computed tomography (MDCT), ie, 1) mid-diastolic (75% of RR) 1 beat scan (MD 1 beat, N=761(73.8%)) for HR≤60, 2) mid-diastolic (75% of RR) 2 beat scan (MD 2 beat, N=135) for 61≤HR≤65, 3) end-systolic and mid-diastolic (37–80% of RR) 2 beat scan (ES-MD 2 beat, N=92) for 66≤HR≤75, 4) end-systolic (R+280–430 ms) 2 beat scan (ES 2 beat, N=21) for 76≤HR≤80, and 5) end-systolic (R+250–400 ms) 3 beat scan (ES 3 beat, N=22) for 81≤HR≤105. Image quality was classified into 3 categories (excellent (3 points), acceptable (2 points), and unacceptable (1 point)). Scanning time, DLP.e and image quality score were 1.4±0.1 s, 220±59 mGy·cm, 3.0±0.2 points in MD 1 beat, 2.2±0.2 s, 434±118 mGy·cm, 2.9±0.3 points in MD 2 beat, 2.1±0.2 s, 729±229 mGy·cm, 2.7±0.5 points in ES-MD 2 beat, 1.9±0.1 s, 432±148 mGy·cm, 2.2±0.6 points in ES 2 beat, and 2.4±0.2 s, 669±152 mGy·cm, 2.3±0.6 points in ES 3 beat respectively. In conclusion, the prospective ECG-gated scan protocol for coronary 320-ADCT angiography in any HR group was considered reasonable and proper for image quality and radiation dose.
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