| Objective: The purpose of this study was to investigate the feasibility of "double low"scan protocol (the low radiation dose and low concentration of contrast medium) intriple-rule-out gemstone CT angiography(TRO-CTA) in patients with acute chest pain.Materials and methods: Sixty patients met the inclusion criteria were randomlyassigned into two different groups to undergo triple-rule-out CTA with respective CTtechnique. The experimental group examined with a100-kV “double low” protocol (theprospectively ECG-triggered combined with the adaptive statistical iterativereconstruction (ASiR) technology for reconstruction of the image). The other group of30patients underwent a120-kV conventional protocol (retrospectively ECG-triggered256-slice spiral CT) served as contrast group. The quality of images by quantitativelycalculating the objective indicators: CNR, SNR and noise，and subjectively rating thesegments of coronary arteries into5levels by two blinded observers. The effective doseobtained by dose length product(DLP) and conversion coefficient of0.017mSv/（mGy·cm） to observe does reduction of patients suffered.RESULTS: There was a statistically significant difference in DLP between group1andgroup2(P <0.05),while the difference in the two groups of SNR (22．3±1.6vs.16.7±3.0, p=0.59)、CNR (26.7±2.0vs.21.3±1.4, p=0.25) was not significant(P>0.05).In each group subjective image quality score was4.6±0.8,4.3±0.9and nosignificant difference. The effective radiation dose in the experimental group wassignificantly lower than the contrast group resulted in about91%reduction (2.50±0.2)mSv vs.28.11±5.0mSv, p <0.0001). CONCLUSIONS: Gemstone Computed Tomography Angiography joint with "doublelow" technology enables triple-rule-out CTA to meet the diagnostic requirements whilesignificantly reduce radiation dose at the same time. TRO-GCTA was worthy ofpopularization and application in screening and diagnosis of patients with acute chestpain. |
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