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Nishida K, Yokoi Y, Yamada A, Takaya N, Yamagiwa K, Kawada S, Mori K, Manabe S, Kanda E, Fujioka T, Kishino M, Tateishi U. Optimal phase analysis of electrocardiogram-gated computed tomography angiography in patients with Stanford type A acute aortic dissection. Eur J Radiol Open 2020; 7:100289. [PMID: 33318968 PMCID: PMC7726336 DOI: 10.1016/j.ejro.2020.100289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 10/27/2022] Open
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.
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Key Words
- AAD, acute aortic dissection
- AC, atrial contraction phase
- AEC, automatic exposure control
- AR, Aortic Regurgitation
- Aorta thoracic
- CTA, computed tomography angiography
- Computed tomography angiography
- D, diastolic phase
- DLP, dose-length-product
- Dissecting
- E, effective dose
- ECG, electrocardiogram
- Electrocardiography
- HR, heart rate
- IVR, isovolumetric relaxation phase
- MPR, multiplanar reconstruction
- RF, rapid filling phase
- RR, R-R interval
- Radiation dose
- S, systolic phase
- SF, slow filling phase
- bpm, beats per minute
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Affiliation(s)
- Kenji Nishida
- Department of Diagnostic Radiology, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki, Japan.,Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-0034, Japan
| | - Yuki Yokoi
- Department of Diagnostic Radiology, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki, Japan
| | - Ayumi Yamada
- Department of Diagnostic Radiology, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki, Japan
| | - Nobuhiro Takaya
- Department of Diagnostic Radiology, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki, Japan
| | - Ken Yamagiwa
- Department of Diagnostic Radiology, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki, Japan
| | - Shuichi Kawada
- Department of Diagnostic Radiology, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki, Japan
| | - Koichi Mori
- Department of Diagnostic Radiology, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki, Japan
| | - Susumu Manabe
- Department of Cardiovascular Surgery, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki, Japan
| | - Eiichiro Kanda
- Department of Nephrology, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki, Okayama, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-0034, Japan
| | - Mitsuhiro Kishino
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-0034, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-0034, Japan
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