Purpose
Coronary transplant vasculopathie (CTV) represents the main reasons for vascular complication in the long term course of cardiac transplant,
resulting in graft failure.
CTV is believed to be based on endothelial damage due to infection,
immunmodulated graft rejection,
ischemic events and pre-existing risk factors like diabetes mellitus,
hypertension and hyperlipidaemia.
Over the time this process of endothelial dysfunction results in a diffuse form of arteriosclerotic vascular damage based on intimal proliferation.
The risk of developing CVT is approximately 10 % per year.
Due to denervation...
Methods and Materials
150 patients in the follow up of cardiac transplant were included in this prospective study.
CCTA was performed using a 128-row dual-source CT scanner (Somatom Definition Flash; Siemens; Germany).
Patients were randomly assigned to one of the three study groups and were scanned using either the conventional retrospective-triggered spiral technique (120 kV/320 mA,
tube current modulation) in group 1,
the prospective ECG-gated sequence technique (120 kV/320 mA,
main padding window 40-70%) in group 2,
or the prospective ECG-gated sequence technique in the systolic phase with...
Results
Comparison of the 3 study groups showed no difference between the groups concerning age,
BMI and mean heart rate (Table 2).
No difference was observed in subjective image quality between the study three groups (Table 3,
Fig.2).
In group 1 90.5% of the coronary segments were rated to have an excellent or good image quality.
89.3% of the segments were rated to image excellent or good image quality in group 2 und 86.8% in group 3.
The percentage of non-diagnostic segments was lowest in group...
Conclusion
Radiation dose of dual source-CCTA in heart transplant recipients can be significantly reduced by using the ECG-gated sequence technique in the systolic phase and automated tube voltage selection,
compared to the ECG-gated sequence technique using a wide padding window and the conventional spiral technique,
while diagnostic image quality is maintained.
References
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Miller CA,
Chowdhary S,
Ray SG,
Sarma J,
Williams SG,
Yonan N,
Mittal TK,
Schmitt M (2011) Role of noninvasive imaging in the diagnosis of cardiac allograft vasculopathy.
Circ Cardiovasc Imaging 4 (5):583-593.
2.
Pichler P,
Loewe C,
Roedler S,
Syeda B,
Stadler A,
Aliabadi A,
Schukro C,
Wolf F,
Zuckermann A,
Lammer J,
Sochor H,
Glogar D (2008) Detection of high-grade stenoses with multislice computed tomography in heart transplant patients.
J Heart Lung Transplant 27 (3):310-316.
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Bastarrika G,
De Cecco CN,
Arraiza...
Personal Information
Contact:
Dietrich Beitzke MD.
Department of Biomedical Imaging and Image-guided Therapy
Division of Cardiovascular and Interventiinal Radiology
Medical University of Vienna
Währinger Gürtel 18-20
1090 Vienna
Austria
Email :
[email protected]
http://radiodiagnostik.meduniwien.ac.at/