Yu Chen MD, Presenter: Nothing to Disclose

Hua Dan Xue, Abstract Co-Author: Nothing to Disclose

Yining Wang MD, Abstract Co-Author: Nothing to Disclose

Lingyan Kong MD, Abstract Co-Author: Nothing to Disclose

Zhiwei Wang MD, Abstract Co-Author: Nothing to Disclose

Jian Cao, Abstract Co-Author: Nothing to Disclose

Zhengyu Jin MD, Abstract Co-Author: Nothing to Disclose

Jiuhong Chen MD, PhD, Abstract Co-Author: Employee, Siemens AG

To evaluate the possibility of the combined head, neck and coronary artery scan in a single electrocardiography(ECG)-gated high-pitch protocol with 128-slice dual source CT system.

47 patients with heart rates (HR) of less than 65 beats per minute (bpm)  were enrolled. All the examinations were performed with dual source CT (Definition FLASH, Siemens Healthcare, Forchheim, Germany). After a test bolus of 15ml, 65-mL contrast material (Ultravist 370 mgI/ml, Bayer Schering) was injected followed by a 50 ml saline chaser at 5 ml/s. The scan range was from the diaphragm to the apex of the skull with the following parameters: 120 kVp, rotation time 0.28 s, pitch of 3.2 and 128×0.6mm slice acquisition with z-flying focal spot. Arterial enhancements were quantified by measuring attenuation values of the aortic arch (AA),bifurcation of common carotid artery (CCA),C7 segments of the internal carotid artery and basilar artery (BA). Contrast noise ratio (CNR) was measured on the level of carotid bifurcation. Two independent neuroradiologists evaluated the visualizations of the circle of Willis with a four-point grading scale (4, excellent; 1, poor). Two independent cardiac radiologists evaluated the image quality of coronary arteries based on the 17-segment American Heart Association classification model with another four-point grading scale (1, excellent; 4, poor). Discrepancies were settled by consensus.

The average scan time and scan range of the 47 patients were 1.3±0.06s and 504±28mm respectively. The average CTDIvol and the corresponding DLP were 4.61±0.38 mGy and 256±25 mGy×cm . The average attenuation values of AA, left and right CCA, left and right C7, BA were 445±80HU, 542±112HU, 531±119HU, 462±100HU, 444±120HU, and 375±95HU respectively. The average CNRs at the level of left and right carotid bifurcation were 34±18 and 35±17 respectively. Consensus-determined image quality in circle of Willis was 3.9±0.3 . Totally 722 segments of coronary arteries were evaluated on the image quality and the average score was 1.02±0.16.

The combined head, neck and coronary arteries scan in a single protocol provided a good image quality with low radiation dose.

The noval 128-slice dual source CT system is able to detect the head, neck and coronary arteries in a single scanning and is recommended in the evlauation of suspected atherosclerotic diseases.

Chen, Y, Xue, H, Wang, Y, Kong, L, Wang, Z, Cao, J, Jin, Z, Chen, J, High-pitch Electrocardiogram-triggered Computed Tomographic Angiography of the Head, Neck and Coronary Artery: Initial Results with a Noval 128-slice Dual Source CT System.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12034849.html