Non-Gated Triple Flash Coronary Computed Tomographic Angiography in Patients with Atrial Fibrillation

Rami M Abazid ； Osama A Smettei ； Akram F Eldesoky ； Hanaa Al Saqqah ； Habiba S Alenzi ； Nora A Altorbak ； Sarah S Altorbak ； Mehboob Ali Dar

《Acta Cardiologica Sinica》 34卷4期 (2018/07) Pp. 352-358

https://doi.org/10.6515/ACS.201807_34(4).20180222A

摘要

Background: Atrial fibrillation (AF) presents a potential challenge when performing coronary computed tomography angiography (CTA). To date, there is no ideal protocol for CTA in patients with AF. We sought to design a protocol for single-heartbeat coronary CTA in patients with AF. Methods: We enrolled 32 patients with AF and a very low probability of coronary artery disease who were referred for CTA to assess pulmonary vein anatomy for catheter ablation. A 256-slice scanner was used. Twelve patients underwent CTA using non-gated triple Flash (NGTF) consisting of three prospective electrocardiogram (ECG)-triggered helical scans with a built-in ECG simulator, while retrospectively gated helical (RGH) was used in 20 patients. Radiation dose, and a 4-point scale was used to assess coronary artery image quality between CTA scan modes. Results: A total of 96 vessels were analyzed. The 4-point score showed no significant differences between the RGH and NGTF scans (2.9 ± 0.6 vs. 2.8 ± 0.8, respectively; p = 0.34). The number of coronary arteries with extensive blurring did not significantly differ between the protocols, and included four vessels (6.6%) in RGH vs. three vessels (8.3%) in NGTF (p = 0.5). Radiation exposure was significantly higher with RGH scans, with a dose-length product of 835 ± 146mGy compared with 382 ± 35 mGy for NGTF (p ＜ 0.0001). Conclusions: Single heartbeat NGTF CTA has comparable image quality and significantly lower radiation dose compared to RGH scans in patients with AF. Whether this protocol can be used in next-generation computed tomography scanners has yet to be determined.

關鍵字

Computed tomographic angiography ； Flash spiral ； Non-gated ； Radiation ； Retrospectively gated helical