title: ECG-triggered high-pitch CT for simultaneous assessment of the aorta and coronary arteries.
abstract: OBJECTIVE
  To study the image quality of ECG-gated-computed tomography (CT) acquisition with a high-pitch CT imaging for the exploration of both the aorta and coronary arteries.
  
  
  METHODS
  Eighty-four patients underwent high-pitch ECG-gated aortic CT without β-blockers with iterative reconstruction algorithms. Contrast-to-noise ratio (CNR) between vessels and adjacent perivascular fat tissue were calculated on the aorta and the coronary arteries. Dose-length-products (DLP) were recorded. Two blinded readers graded image quality of the aorta and the coronary arteries on a 3-point scale. Coronary artery stenoses were compared with coronary angiograms in 24 patients. Kappa values were calculated.
  
  
  RESULTS
  High-pitch acquisition resulted in a mean DLP of 234 ± 93 mGy cm(4.2 mSv) for an acquisition of the entire aorta, (mean 73 ± 16 bpm). CNR for ascending aorta was 10.6 ± 4 and CNR for coronary arteries was 9.85 ± 4.1. Image quality was excellent in 79/84 patients (94%), and excellent or moderate but diagnostic in 1087/1127 coronary artery segments (96%). 74 significant stenoses were observed, and 38/40 significant stenoses were confirmed by coronary angiography (K = 0.91, Sensitivity = 0.97, Specificity = 0.98).
  
  
  CONCLUSIONS
  High-pitch ECG-gated aortic CT with iterative reconstructions allows an accurate exploration of both aorta and coronary arteries during the same acquisition, with limited dose deposition, despite the lack of β-blockers and relatively high heart rate. Radiologists need to be aware of the necessity to analyze and report coronary artery disease in aortic examination.
authors.affiliation: Division of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland; Pulmonary Hypertension Program, University Hospitals of Geneva, Geneva, Switzerland. Electronic address: anne-lise.hachullalemaire@hcuge.ch.
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Hachulla
authors.affiliation: Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France; University Paris Diderot, Sorbonne Paris Cité, Paris, France; INSERM U1149, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3, Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.affiliation: Pulmonary Hypertension Program, University Hospitals of Geneva, Geneva, Switzerland; Cardiology Division, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Noble
authors.affiliation: Division of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland.
authors.forename: Christoph D
authors.initials: CD
authors.lastname: Becker
authors.affiliation: Division of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland; Pulmonary Hypertension Program, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Xavier
authors.initials: X
authors.lastname: Montet
authors.affiliation: Division of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland; Pulmonary Hypertension Program, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Vallée
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001011:Aorta / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001027:Aortography / Q000379:methods*; D016477:Artifacts; D055424:Cardiac-Gated Imaging Techniques; D000072226:Computed Tomography Angiography; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015588:Observer Variation; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D059629:Signal-To-Noise Ratio; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Aortic CTA; Cardiovascular imaging; Coronary CTA; ECG-gated high-pitch protocol; Iterative reconstructions