Optimal phase analysis of electrocardiogram-gated computed tomography angiography in patients with Stanford type A acute aortic dissection

• Main Authors: Kenji Nishida, Yuki Yokoi, Ayumi Yamada, Nobuhiro Takaya, Ken Yamagiwa, Shuichi Kawada, Koichi Mori, Susumu Manabe, Eiichiro Kanda, Tomoyuki Fujioka, Mitsuhiro Kishino, Ukihide Tateishi
• Format: Article
• Language: English
• Published: Elsevier 2020-01-01
• Series: European Journal of Radiology Open
• Subjects: Dissecting; Computed tomography angiography; Radiation dose; Electrocardiography; Aorta thoracic
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352047720300782

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.