1. Can multiphase dynamic CT angiography provide a better assessment of aortic dissection compared with the standard triphasic protocol?
- Author
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Chun-yan Lu, Ying-qiang Guo, Xiao-hui Zhang, Yi-ke Diao, Zhen-lin Li, and Hong-li Bai
- Subjects
Adult ,Male ,medicine.medical_specialty ,Computed Tomography Angiography ,Image quality ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Image Processing, Computer-Assisted ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Four-Dimensional Computed Tomography ,Aged ,Computed tomography angiography ,Aortic dissection ,Protocol (science) ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Radiation dose ,Reproducibility of Results ,General Medicine ,Middle Aged ,medicine.disease ,Aortic Aneurysm ,Acquisition Protocol ,Aortic Dissection ,Angiography ,Radiographic Image Interpretation, Computer-Assisted ,Female ,Radiology ,Dynamic ct ,business ,Nuclear medicine - Abstract
Background Acute aortic dissection (AD) is a life-threatening medical emergency. It has been debated whether the multiphase dynamic computed tomography angiography (CTA) protocol is superior to the standard triphasic protocol for revealing the characteristics of AD. Purpose To examine two multiphase dynamic protocols, Dynamic four-dimensional (4D) CTA using the shuttle mode and Flash 4D CTA using the high-pitch mode for the assessment of AD and to compare them with the standard triphasic protocol. Material and Methods A total of 54 consecutive patients were randomly and equally assigned to three groups and scanned with a second-generation DSCT scanner. Groups A, B, and C were assessed with the Dynamic 4D CTA in the shuttle mode, the Flash 4D CTA in the high-pitch mode, and the standard triphasic acquisition protocol, respectively. Image quality of all patients was evaluated. The effective radiation dose (ED) was recorded. Results In 54 patients, CTA images could display the true and false lumens, the intimal flap, the entry tear, and branch vessel involvement in the AD. Compared with group C, additional diagnostic information was obtained in groups A and B, including the dynamic enhancement delay between the true and false lumens (A = 18, B = 18); the presence of membrane oscillation (A = 8, B = 14); dynamic ejection of the contrast material from the true lumen into the false lumen (A = 6, B = 7); and the dynamic obstruction of the left renal artery (B = 2). The ED in these three groups was significantly different ( P Conclusion Compared to the standard triphasic protocol, the multiphase dynamic CTA protocol is feasible and is able to reveal additional diagnostic information. Therefore, we recommend using the high-pitch, dual-source multiphase dynamic CTA to assess ADs.
- Published
- 2017