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Factors influencing delay time and coronary arterial density during coronary angiography with DSCT
Lijun Tang1, Xiaomei Zhu, Yi Xu
1Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Insights
Heart rate, gender, and cardiac dimensions influence coronary CT angiography timing and density. Optimizing contrast media protocols using these patient factors can improve diagnostic image quality for coronary artery disease.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Medical Imaging
Background:
- Coronary CT angiography (CTA) is crucial for diagnosing coronary artery disease.
- Optimal CTA image quality depends on precise delay time and coronary artery density.
- Patient-specific factors significantly influence these imaging parameters.
Purpose of the Study:
- To investigate factors affecting delay time and coronary artery density in dual-source CT coronary angiography.
- To identify patient characteristics that can predict optimal contrast enhancement.
- To inform adjustments in contrast media protocols for improved CTA diagnostics.
Main Methods:
- Retrospective analysis of 116 patients undergoing cardiac dual-source CT.
- Recorded and measured patient factors: gender, age, height, weight, heart rate, cardiac/thoracic diameters, BSA, and CTR.
- Utilized regression analysis to determine the influence of these factors on delay time and coronary artery density.
Main Results:
- Delay time was inversely correlated with heart rate and shorter in women; it increased with larger transverse cardiac diameter.
- Coronary arterial density decreased with higher heart rate and increased weight.
- Predictive formulas were derived for delay time and coronary arterial density based on these factors.
Conclusions:
- Heart rate, gender, and transverse cardiac diameter are key determinants of delay time.
- Heart rate and weight significantly impact coronary arterial density.
- These identified factors allow for pre-procedural adjustment of contrast media flow rate and dosage to optimize CTA quality.
Background:
CT angiography (CTA) plays an important role in diagnosing coronary arterial disease. Delay time and density of the coronary arteries related with patient-specific factors are essential for getting an optimal CTA image.
Purpose:
To investigate various factors influencing delay time and coronary arterial density during coronary CTA with dual source CT.
Material And Methods:
One hundred and sixteen consecutive subjects who underwent cardiac DSCT with retrospective ECG-gating were included. Factors including gender, age, height, weight, transversal cardiac diameter (TCD), transversal thoracic diameter (TTD), heart rate (HR), body surface area (BSA = [weight × height/3600](1/2)) and cardiothoracic ratio (CTR = TCD/TTD) were recorded, measured and calculated before administration of contrast media during coronary CT angiography. Delay time was determined as duration from the beginning of the injection to the density in the descending aorta at the level of right main pulmonary artery reaching a threshold of 100 HU. Coronary arterial density was measured at the mid portion of the right coronary artery. Regression analysis and stepwise regression analysis were used to investigate the influence of these factors on delay time and coronary arterial density.
Results:
Delay time decreased with an increasing HR and it was shorter in women than men. Delay time increased with an increasing TCD. Delay time could be predicted by the formula: DT = 16.651-0.110 × HR + 1.902 × gender + 0.394 × TCD (where DT is abbreviation for delay time, gender is 0 for women and 1 for men). Coronary arterial density decreased with an increasing HR and weight. Coronary arterial density could be predicted by the formula: CAD = 923.42-4.099 × HR-3.293 × weight (CAD = coronary arterial density). There was no relationship between the other factors mentioned above and delay time or coronary arterial density.
Conclusion:
Delay time is influenced by HR, gender and TCD. Coronary arterial density also changes with HR and weight. So HR, gender, TCD and weight can be used to adjust flow rate and dosage of contrast media before administration of contrast media during coronary CT angiography.
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