The ascending aortic image quality and the whole aortic radiation dose of high-pitch dual-source CT angiography

Abstract

BackgroundAortic dissection is a lift-threatening medical emergency associated with high rates of morbidity and mortality. The incidence rate of aortic dissection is estimated at 5 to 30 per 1 million people per year. The prompt and correct diagnosis of aortic dissection is critical. This study was to compare the ascending aortic image quality and the whole aortic radiation dose of high-pitch dual-source CT angiography and conventional dual-source CT angiography.MethodsA total of 110 consecutive patients with suspected aortic dissection and other aortic disorders were randomly divided into two groups. Group A underwent traditional scan mode and Group B underwent high-pitch dual-source CT scan mode. The image quality and radiation dose of two groups were compared.ResultsClose interobserver agreement was found for image quality scores (κ = 0.87). The image quality of ascending aorta was significantly better in the high-pitch group than in the conventional group (2.78 ± 0.46 vs 1.57 ± 0.43, P < 0.001). There was no significant difference of the CT attenuation values, the aortic image noise and SNR between two groups. The mean radiation dose of high-pitch group was also significantly lower than that of conventional group (2.7 ± 0.6 mSv vs. 3.9 ± 0.9 mSv, P < 0.001).ConclusionsHigh-pitch dual-source CT angiography of the whole aorta can provide motion-artifact-free imaging of the ascending aorta at a low radiation dose compared to conventional protocol.

High-Pitch, Low-Voltage and Low-Iodine-Concentration CT Angiography of Aorta: Assessment of Image Quality and Radiation Dose with Iterative Reconstruction

“…Multislice computed tomography angiography (CTA) has become the preferred method to assess aortic diseases [ 1 – 6 ]. However, X-ray radiation and iodine hazards are the major concern associated with CTA, as repeat CTA scans are commonly performed during pre- and postoperative assessments of aortic disease [ 7 – 9 ]. To address these concerns, clinical studies have recently reported the use of the second-generation dual-source computed tomography (DSCT) Flash protocol for dose reduction.…”

“…High-pitch CTA of the aorta was shown to reduce radiation exposure by 45–50% and to allow the use of less contrast medium (CM) while maintaining vessel attenuation at a diagnostic level [ 12 ]. Liu et al reported that DSCT can provide motion artifact-free imaging of the ascending aorta at a low radiation dose compared to the conventional protocol [ 7 ]. However, that study used a CM with a high concentration of iodine (370 mg I/mL).…”

3D CT Angiography of Infrarenal Abdominal Aortic Aneurysm with Associated Ectopic Pelvic Kidney: A Case Report of Rare Concomitance

“…To reduce the X-ray radiation hazards and the amount of iodine hazards, high-pitch scanning mode, lowering tube voltage and low-concentration CM are combined. IR technology is used to overcome a limitation that low tube voltage may result in increased noise, and to improve image quality [15]. To our knowledge, this is the first report of demonstrating the use of CTA of low-concentration CM (270mg I/mL) combined low radiation dose and IR showing the rare concomitance with good image quality, and the recorded case of AAA regular surveillance with a native pelvic kidney.…”

Non–Electrocardiogram-Triggered 70-kVp High-Pitch Computed Tomography Angiography of the Whole Aorta With Iterative Reconstruction

“…This may be helpful for improved differentiation between ascending aortic dissection and motion artifacts. This potential advantage of high-pitch acquisition for aortic CTA has been reported in several recent studies, 6,10,26,27 further emphasizing the relevance of non-ECG-triggered high-pitch CTA for the detection of thoracic aortic diseases, especially for precise characterization of the proximal extent of dissection, intramural hematoma and the involvement of coronary artery ostia. 6 However, we also noted some potential issues regarding image quality assessment when using the 70-kVp CTA protocol.…”