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Observational Study
. 2018 Aug;97(34):e11798.
doi: 10.1097/MD.0000000000011798.

Diagnostic performance of low-radiation-dose and low-contrast-dose (double low-dose) coronary CT angiography for coronary artery stenosis

Wei Zhang  1 , Zhaogui Ba, Zhenqiang Wang, Huaying Lv, Jun Zhao, Yonghua Zhang, Feixue Zhang, Lei Song
Affiliations
Observational Study

Diagnostic performance of low-radiation-dose and low-contrast-dose (double low-dose) coronary CT angiography for coronary artery stenosis

Wei Zhang et al. Medicine (Baltimore). 2018 Aug.

Abstract

The aim of the present study was to evaluate the diagnostic accuracy of low-radiation-dose and low-contrast-dose (double low-dose) coronary computed tomography angiography (CTA) for coronary artery stenosis in patients with suspected coronary artery disease (CAD).Totally 88 patients with suspected CAD were divided in the routine and double low-dose groups. Subjective image quality (IQ) was scored and diagnostic performance for detecting ≥50% stenosis was determined with the invasive coronary angiography. IQ and diagnostic performance were analyzed and compared between the 2 groups.There was no significant difference in the IQ of coronary artery between the routine and double low-dose groups, with good inter-observer agreement for the IQ. There were no significant differences in the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy on the per-patient, per-vessel, or per-segment level between the routine and double low-dose groups. The contrast medium injection volume in the double low-dose group was reduced by 37.1% compared with the routine-dose group. The effective dose in the double low dose was reduced by 44.5% compared with the routine-dose group.Double low-dose coronary CTA with IR can acquire satisfactory IQ and have high diagnostic sensitivity, specificity, and accuracy for the detection of coronary artery stenosis.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Prospectively gated transaxial (PGT) 256-slice coronary computed tomography angiography (CTA) in a 69-year-old man with chest pain. PGT 256-slice coronary CTA (effective radiation dose, 1.01 mSv) was performed in a 69-year-old man (weighing 70.0 kg; body mass index, 26.5 kg/m2) with chest pain. Totally 42 mL contrast medium (350 mgI/mL) was delivered, at the injection rate of 4.2 mL/s. (A) Curved multiplanar reformation of left anterior descending (LAD) showed significant stenosis in the proximal segment caused by the mixed plaque. (B) Catheter angiography of the LAD.
Figure 2
Figure 2
Prospectively gated transaxial (PGT) 256-slice coronary computed tomography angiography (CTA) in a 72-year-old man with chest pain. PGT 256-slice coronary CTA (effective radiation dose, 1.02 mSv) was performed in a 72-year-old man (weighing 70.0 kg; body mass index, 24.2 kg/m2) with chest pain. Totally 49 mL contrast medium (350 mgI/mL) was delivered at the injection rate of 4.9 mL/s. Curved multiplanar reformation of the left anterior descending (A) and right coronary artery (RCA; B) showed significant stenosis in the proximal segment caused by calcified plaque, which were false positive according to the catheter angiography (C, D).
Figure 3
Figure 3
Prospectively gated transaxial (PGT) 256-slice coronary computed tomography angiography (CTA) in a 56-year-old man with chest pain. PGT 256-slice coronary CTA (effective radiation dose, 1.28 mSv) was performed in a 56-year-old man (weighing 67.0 kg; body mass index, 27.2 kg/m2) with chest pain. Totally 40 mL contrast medium (350 mgI/mL) was delivered at the injection rate of 4.0 mL/s. (A, B) Volume-rendering curved multiplanar reformation of the right coronary artery (RCA) showed significant stenosis in the distal segment caused by poor blood filling. (C) Catheter angiography of the RCA.
See this image and copyright information in PMC

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