Optimal phase analysis of electrocardiogram-gated computed tomography angiography in patients with Stanford type A acute aortic dissection. (2020)

• Record Type: Journal Article
• Authors: Nishida, Kenji; Yokoi, Yuki; Yamada, Ayumi; Takaya, Nobuhiro; Yamagiwa, Ken; Kawada, Shuichi; Mori, Koichi; Manabe, Susumu; Kanda, Eiichiro; Fujioka, Tomoyuki; Kishino, Mitsuhiro; Tateishi, Ukihide
• Is Part Of: European journal of radiology open. Volume 7(2020)
• Publication Date: 2020
• Subjects: AAD acute aortic dissection -- CTA computed tomography angiography -- ECG electrocardiogram -- HR heart rate -- bpm beats per minute -- AEC automatic exposure control -- DLP dose-length-product -- E effective dose -- MPR multiplanar reconstruction -- RR R-R interval -- S systolic phase -- D diastolic phase -- IVR isovolumetric relaxation phase -- RF rapid filling phase -- SF slow filling phase -- AC atrial contraction phase -- AR Aortic Regurgitation; Dissecting -- Computed tomography angiography -- Radiation dose -- Electrocardiography -- Aorta thoracic; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2020.100289
• Languages: English
• ISSNs: 2352-0477

Abstract

Highlights: Patients with Stanford type A acute aortic dissection with perfused false lumen. We created and randomized 10 cross-sectional images of each phase for 20 patients. We scored these images depending on the degree of flap stoppage. Image scores were significantly better in the 65 %–100 % R-R interval group. Abstract: Objective: To determine the phase that facilitates flap observation of the ascending aorta in Stanford type A acute aortic dissection with perfused false lumen. Methods: We reconstructed retrospective Electrocardiogram-gated Computed Tomography Angiography images of the ascending aorta of all 20 patients to 20 phases of curved-multiplanar reconstruction in 5% increment. One radiologist created and randomized 10 cross-sectional images of each phase for every patient and two radiologists scored these images on a 5-point scale depending on the degree of flap stoppage. We calculated the average score for each phase of each case and compared them among the three groups. Results: Image scores were significantly better in the 65 %–100 % R-R interval group than those in the 5%–30 % (p < 2e-16) and 35 %–60 % R-R interval groups(p = 7.2e-10). Similar scores were observed in the Heart Rate > 70 group (p = 0.00039, 2.2e-14). Moreover a similar tendency was observed in the arrhythmia group (p = 0.0035, 0.294). No difference was found in the degree of flap stoppage in the 65 %–100 % R-R interval group between the Heart Rate > 70 and Heart Rate ≤ 70 groups (p = 0.466) and between the arrhythmia and non-arrhythmia groups (p = 0.1240). Conclusion: In observing the ascending aorta, We obtained a good image at 65 %–100 % R-R interval and similar tendency was observed in the patients with arrhythmia.