Cemil ÇOLAK, Zeynep Maraş ÖZDEMİR, Ayşegül Sağır KAHRAMAN, Ramazan ÖZDEMİR, Jülide YAĞMUR, Nusret AÇIKGÖZ, Cemile Ayşe GÖRMELİ

256 kesitli çift tüplü bilgisayarlı tomografi cihazında prospektif EKG tetiklemeli ve retrospektif EKG kapılamalı teknikle çekilen koroner BT anjiografi ıncelemelerinde radyasyon dozu karşılaştırması

Giriş: Koroner arter hastalığı, aterosklerotik plakların meydana getirdiği, önemli mortalite ve morbiditeye sahip sık görülen kardiyovasküler bir hastalıktır. Bilgisayarlı tomografi ile koroner anjiografi tetkiki giderek artan sıklıkta invaziv kateter anjiografi yerine kullanılmaya başlanmıştır. Biz de bu çalışmamız ile koroner arter hastalıklarının değerlendirilmesi için bilgisayarlı tomografi kullanılarak prospektif EKG tetiklemeli ve retrospektif EKG kapılamalıteknikle çekilen koroner anjiografi incelemelerinde efektif radyasyon dozlarını saptamayı amaçladık. Gereç ve Yöntemler: 256 kesitli çift tüplü bilgisayarlı tomografi cihazı ile koroner anjiografi çekilen 326 hasta değerlendirildi. Çalışmamızda, hastaların kalp hızına bağlı olarak 3 farklı çekim tekniği kullanarak teknikler arasındaki efektif radyasyon dozunu karşılaştırdık. Bulgular: Teknik I ile çekilen 195 hastanın kalp hızı ortalama 96,1 atım/dk, teknik II ile yapılan 103 incelemede kalp hızı ortalama 80,7 atım/dk, teknik III ile yapılan 28 görüntülemede ise kalp hızı ortalama 57,1 atım/dk olarak saptandı. Ayrıca, ortalama efektif radyasyon dozları; teknik I ile 1,15 mSv, teknik II ile 3,98 mSv ve teknik III ile 10 mSv olarak hesaplandı. Sonuç: Prospektif EKG tetiklemeli teknikle bilgisayarlı tomografi kullanılarak çekilen koroner anjiografi, retrospektif EKG kapılamalı teknikle karşılaştırıldığında düşük efektif radyasyon dozuna neden olmaktadır. Düşük radyasyon dozunda ve optimal görüntü kalitesinde incelemeler elde etmek için, çekim hastanın kalp hızına bağlı olarak en uygun teknik belirlenerek yapılmalıdır.

Radiation dose comparison between prospectively ECG-triggered and retrospectively ECG-gated techniques of coronary computed tomography angiography on 256-slice dual source CT scanner

Introduction: Coronary artery disease is an important cause of morbidity and mortality which is a common cardiovascular disease and the clinical presentation of atherosclerosis. Coronary computed tomography angiography is increasingly being used instead of the invasive catheter angiography. We aimed to determine the effective radiation dose of retrospectively ECG gated and prospectively ECG triggered technique of coronary computed tomography angiography for the assessment of coronary artery diseases. Materials and Methods: Three hundred and twenty six patients who underwent coronary computed tomography angiography were evaluated by using a 256 slice dual source scanner. We have used 3 different techniques depended to the heart rate of patients and compared the effective radiation dose between the techniques in our study. Results: The mean heart rates was demonstrated as 96,1 beat/minute in 195 patients with technique I, 80,7 beat/minute in 103 patients with technique II and 57,1 beat/minute in 28 patients with technique III. Also, the mean effective doses were calculated as 1,15 mSv in technique I, 3,98 mSv in in technique II and 10 mSv technique III. Conclusion: Prospectively ECG-triggered coronary computed tomography angiography ensures low effective radiation dose compared with retrospectively ECG gated for assessment of coronary artery diseases. Depended to the heart rate of the patient, the appropriate technique should be determined to obtain low radiation dose and an optimal image quality.

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