Estimation of informativeness and methodological features of cardiac CTA in diagnostics of ischemic heart disease

DOI: https://doi.org/10.25512/DIR.2017.11.2.02

For quoting:
Djuraeva N.M., Ikramov A.I., Pirnazarov M.M., Maksudov M.F., Abdukadirov D.A. "Estimation of informativeness and methodological features of cardiac CTA in diagnostics of ischemic heart disease". Journal Diagnostic & interventional radiology. 2017; 11(2); 24-29.

authors:

Djuraeva N.M.

Ikramov A.I.

Pirnazarov M.M.

Maksudov M.F.

Abdukadirov D.A.

keywords:

coronary ischemic disease

coronary arteries

computed tomography

cardiac CTA

radiation dose

Abstract:

Aim: was to increase diagnostic value of cardiac CTA (CCTA) by estimation of the CCTA informative value in CA (Coronary arteries) diseases and optimization of OOTA procedure for reducing of radiation dose (RD).

Materials and methods: CCTA informative value in CA diseases was assessed on the base of data of 200 patients (average age of patients was 60,4 (from 35 to 80 years), men/women ratio: 1.94:1(132/68). Parameters of coronary stenosis severities: its localization, extension, degree and characteristics of coronary stenosis. The study was performed with GE Optima 660 128-slice scanner and Missouri Ulrich injector with bolus injecting 60-100 ml of nonionic contrast media (350 mg/ml) at 4-6 ml/sec injector rate. For data processing used: «Auto Coronary Analysis» and «Auto Ejection Fraction» programs at - AW5 workstation.

Results: discovered various severity degrees of atherosclerotic lesions based stenosis intensity up to 50% (46 /23,5%), 50-60% (65/33%), 60-70% (35/17,9%), 70-80% (26/13,5%), 80% and more (23/11,8%). CCTA data coincided with conventional coronary angiography in 89% cases. RD decreasment was achieved by: pitch change depending on heart rate, scan area optimization (reduction), kV and mAc with radiation exposure decline in CCTA to 7,0-8,0 mSv In pitch value increasing to 1,48 - RD decreased to 45% (20 mSv). In prospective synchronization with ECG, RD decreased to 65% (7-12 mSv) as X-Ray tube radiates the highest RD at 70% cardiac cycle phase (120kV/180-200mAc), in other phases (80kV/100 mAc) RD values were lower.

Conclusion: CCTA is a valid non-invasive method in CA pathology diagnostics enabling accurate identification of stenosis location, extent, degree and characteristics. Scanning protocol individualization in CCTA enables significant reduce of RD.

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