High-pitch dual-source CT angiography of the aortic valve-aortic root complex without ECG-synchronization.
OBJECTIVE
To compare image quality and radiation dose of high-pitch computed tomography angiography(CTA) of the aortic valve-aortic root complex with and without prospective ECG-gating compared to a retrospectively ECG-gated standard-pitch acquisition.


METHODS
120 patients (mean age 68±13 years) were examined using a 128-slice dual-source CT system using prospectively ECG-gated high-pitch (group A; n=40), non-ECG-gated high-pitch (group B; n=40) or retrospectively ECG-gated standard-pitch (C; n=40) acquisition techniques. Image quality of the aortic root, valve and ascending aorta including the coronary ostia was assessed by two independent readers. Image noise was measured, radiation dose estimates were calculated.


RESULTS
Interobserver agreement was good(κ=0.64-0.78). Image quality was diagnostic in 38/40 patients (group A), 37/40(B) and 38/40(C) with no significant difference in number of patients with diagnostic image quality among all groups (p=0.56). Significantly more patients showed excellent image quality in group A compared to groups B and C (each, p<0.01). Average image noise was significantly different between all groups (p<0.05). Mean radiation dose estimates in groups A and B (each; 2.4±0.3 mSv) were significantly lower compared to group C (17.5±4.4 mSv; p<0.01).


CONCLUSIONS
High-pitch dual-source CTA provides diagnostic image quality of the aortic valve-aortic root complex even without ECG-gating at 86% less radiation dose when compared to a standard-pitch ECG-gated acquisition.
Karlo
Christoph
C
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. christoph.karlo@usz.ch
Leschka
Sebastian
S
Goetti
Robert Paul
RP
Feuchtner
Gudrun
G
Desbiolles
Lotus
L
Stolzmann
Paul
P
Plass
Andre
A
Falk
Volkmar
V
Marincek
Borut
B
Alkadhi
Hatem
H
Baumüller
Stephan
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001027:Aortography; D055424:Cardiac-Gated Imaging Techniques; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed