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Application of low tube voltage in CTA before transcatheter aortic valve replacement
Received:March 17, 2021  Revised:May 13, 2021  Click here to download the full text
Citation of this paper:XÜ Bing,ZHU Jie,LU Jian-ping,ZHAO Bing-hui,TIAN Bing,YIN Wei,ZHOU Zhen,WANG Min-jie.Application of low tube voltage in CTA before transcatheter aortic valve replacement[J].Chinese Journal of Clinical Medicine,2021,28(4):682-687
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Author NameAffiliationE-mail
XÜ Bing Department of Radiology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China  
ZHU Jie Department of Radiology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China  
LU Jian-ping Department of Radiology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China cjr.lujianping@vip.163.com 
ZHAO Bing-hui Department of Radiology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China  
TIAN Bing Department of Radiology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China  
YIN Wei Department of Radiology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China  
ZHOU Zhen Department of Radiology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China  
WANG Min-jie Department of Radiology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China  
Abstract:Objective: To discuss the application value of 320-slice CT low tube voltage variable helical pitch (VHP) technique in preoperative evaluation of patients undergoing transcatheter aortic valve replacement (TAVR) by analyzing the subjective and objective quality of preoperative CTA image of patients. Methods: A total of 96 cases of patients who planned to undergo aortic valve replacement from January 2016 to December 2020 were prospectively included. All patients underwent preoperative CTA examination with 320-slice spiral CT variable helical pitch (VHP) technique. According to the random number method, the patients were divided into 80 kV, 100 kV, and 120 kV groups, with 32 patients in each group, the dosage of contrast agent was 0.9, 1.1, and 1.2 mL/kg, and the flow rate was 3, 3.5, and 4 mL/s. Images of each group were evaluated using an iterative algorithm (AIDR), and image quality was evaluated using both subjective (Likert 5 method) and objective assessment methods (CT value, SD value, and contrast to noise ratio[CNR]). The image qualities of the left and right common carotid artery, ascending aortic root, and left and right femoral artery were compared among the 3 groups. Results: There were no statistically significant differences in gender, age, body mass index (BMI), and scanning time among the three groups. The significant differences in subjective scores were only observed in the left and right femoral artery among the three groups (P<0.0 1). There were significant differences in CT values at the left and right common carotid artery and left and right femoral artery among the three groups (P<0.001). There were significant differences in SD and CNR values at all levels among the three groups (P<0.001). The dosage of contrast agents in the 80 kV group ([57.70±9.01] mL) was lower than that in the 100 kV group ([71.80±10.37] mL) and 120 kV group ([75.20±11.08] mL, P<0.01). In the 80 kV, 100 kV, and 120 kV groups, the dose length product (DLP) of patients was (1 096.88±155.20) mGy×cm, (963.02±137.90) mGy×cm, and (1 048.53±168.20) mGy×cm, and the mean effective radiation dose was 16.45, 14.44, and 15.73 mSv, respectively. The patients in the 100 kV group received the lowest radiation dose (P<0.05). Conclusions: The 320-slice CT VHP technique can obtain good image quality at the tube voltages of 80, 100, and 120 kV, among which, the dosage of contrast agent is least at 80 kV, and the radiation dose received is lowest at 100 kV.
keywords:320-slice CT  transcatheter aortic valve replacement  variable helical pitch  image quality  low tube voltage
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