Koroner Bilgisayarlı Tomografik Anjiografide Koroner Damarların Görüntülenmesine Katkı Sağlayan Faktörlerin Gözden Geçirilmesi ve Bunların Çekim Pratiğine Yansıması

Öz

Koroner bilgisayarlı tomografik anjiografide (BTA) koroner damarların opasifikasyonuna etki eden faktörlerin gözden geçirilmesi ve bunların çekim pratiğine yansımalarını değerlendirmeyi amaçladık. Retrospektif olarak koroner BTA çekimleri değerlendirilmiş olup sol ana koroner arter (LMCA) santral kesiminden yapılan ölçümlere göre 300-400 Hounsfield Unit aralığında yapılan ölçümler optimum kabul edilip, bunun dışındakiler optimum olmayan grup olarak kabul edildi. İki grup kilo, kalp atımı, tüp akımı, kontrast miktarı, region of interest (ROI), end diastolik fazda midventriküler hatta sol ventrikül kısa aks çapı, Field of View (FOV), kontrast+ serum fizyolojik (SF) verilme süresi kıyaslandı. İstatistiksel anlamlılık sınırı olarak p<0,05 kabul edildi. Çalışmaya 83 hasta dahil edilmiş olup hastaların yaş ortalamaları ve standart sapması 58 ± 18.56 yıl olarak saptandı. Çalışmada LMCA dansitesine göre 35 hasta (42.3%) optimum olmayan grupta olup, 48 hasta (57.8%) optimum olan gruptaydı. Çalışmada LMCA dansitesine göre 48 hasta (57.8%) optimum olan grupta olup, 35 hasta (42.3%) optimum olmayan gruptaydı. Koroner BTA çekimi optimum olan hastalarda optimum olmayan hastalara göre kilo değerleri (p<0.05), kontrast madde miktarı (p<0.01), FOV değerleri (p<0.05), kontrast+SF verilme süresi değerleri (p<0.01) anlamlı düzeyde yüksek, tüp akımı (p<0.05) anlamlı düzeyde düşük olarak saptandı. Optimum olmayan BTA tetkikine etkili bağımsız değişkenlerle oluşturulan logistik regresyon modeli sonucunda; tüp akımı ve kontrast madde miktarı anlamlı bulunmuştur. Koroner BTA çekimlerini daha optimal düzeye taşıyabilmek için hasta bazlı çalışılmalı, kontrast protokollerini değiştirerek hastaya uyarlamalıyız.

Anahtar Kelimeler

• Koroner Bilgisayarlı Tomografi Anjiyografi
• Bilgisayarlı Tomografi
• Koroner Arterler
• Koroner Arter Görüntüleme
• Koroner Arter Kontrast İyileştirme

Review of Factors Contributing to the Imaging of the Coronary Arteries in Coronary Computed Tomography Angiography and Implications for Imaging Practice

Öz

We aimed to review factors affecting the opacification of the coronary arteries in coronary computed tomography angiography (CTA) and evaluate their reflections on imaging practices. Coronary CTA images were retrospectively evaluated. The measurements performed from the central part of the left main coronary artery (LMCA) were divided into two groups optimal CTA (in the range of 300-400 Hounsfield units) and non-optimal CTA. Weight, heart rate, tube current, amount of contrast agent, region of interest (ROI), the short axis diameter of the left ventricle at the midventricular line in the end-diastolic phase, the field of view (FOV), and contrast + saline injection time were compared between the two groups. P<0.05 was accepted as the statistical significance limit. Eighty-three patients were included in the study, and their mean age and standard deviation were 58±18.56 years. In the study, 35 patients (42.3%) had non-optimal CTA and 48 (57.8%) had optimal CTA according to LMCA density. Patient weight (p<0.05), amount of contrast (p<0.01), FOV (p<0.05), and contrast + saline injection time (p<0.01) were significantly higher and tube current was significantly lower (p < 0.05) in the optimal CTA group compared to the non-optimal CTA group. As a result of the logistic model established with independent variables that affected the non-optimal CTA scan, tube current and amount of contrast agent were found to be significant. To bring coronary CTA to a more optimal level, radiologists should work on a patient basis, revising contrast agent protocols and adapting them to each patient.

Anahtar Kelimeler

• Coronary Computed Tomography Angiography
• Computed Tomography
• Coronary Arteries
• Imaging of Coronary Arteries
• Coronary Artery Contrast Enhancement

Kaynakça

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