The purpose of this study was to investigate using split-bolus contrast injection (SPBI) with volume scanning of the heart and aortic root with helical scanning of the access route, compared to single bolus contrast injection (SI) with variable helical pitch scanning (VHP) of the heart and aortic root and access route in a preoperative evaluation before transcatheter aortic valve implantation (TAVI). Thirty-five patients who underwent preoperative CT before TAVI using SPBI (contrast media: 24.5 mgI /kg/s, injected for 12 s for heart scan and then injected for 8 s for access route) were examined. Electrocardiogram (ECG) gated scans of the heart were performed by volume scan, after a period of time, non-gated helical scans of the aorto-iliac were performed (SPBI method). For comparison, 40 patients who had a single bolus injection (26.5 mg I/kg/s, injected for period of the scan time plus 3 s) and a VHP scan (SI method) before the SPBI method was performed were included in the study. The image qualities of the coronary arteries, aortic root, and access route (aorta-iliac), as well as radiation and iodine doses, were assessed. In visual assessment, image quality of coronary artery was significantly better with the SPBI method (grade; excellent: 57.1% in SPBI vs. 24.3% in SI, p = 0.03). There was no significant difference in image quality of the aortic root by visual assessment. The signal-to-noise (SNR) and contrast-to-noise ratio (CNR) of coronary and aortic root were not significantly different between the two methods. The access route showed significantly higher SNR (45.7 ± 11.5 vs. 34.3 ± 9.8, p < 0.001) and CNR (36.0 ± 9.7 vs. 28.0 ± 8.8, p < 0.001) for the SPBI method. The SPBI method compared to SI method reduced iodine dose by 10% and radiation dose by 45%. Preoperative CT imaging before TAVI using SPBI with volume scan is useful and can reduce iodine and radiation doses.

本研究的目的是研究与使用可变螺旋间距扫描 (VHP) 的单次快速注射对比剂 (SI) 相比，使用分次注射对比剂 (SPBI) 对心脏和主动脉根部进行体积扫描以及对进入路径进行螺旋扫描) 在经导管主动脉瓣植入 (TAVI) 前的术前评估中的心脏和主动脉根部和通路路径。对 35 名在 TAVI 前使用 SPBI（造影剂：24.5 mgI/kg/s，注射 12 s 进行心脏扫描，然后注射 8 s 作为通路）进行术前 CT 的患者进行了检查。通过容积扫描对心脏进行心电图（ECG）门控扫描，一段时间后，对主动脉-髂动脉进行非门控螺旋扫描（SPBI方法）。作为比较，40 名单次推注的患者（26.5 mg I/kg/s，该研究包括在扫描时间加 3 s 期间注射）和在执行 SPBI 方法之前的 VHP 扫描（SI 方法）。评估了冠状动脉、主动脉根部和通路（主动脉-髂）的图像质量，以及辐射和碘剂量。在视觉评估中，使用 SPBI 方法的冠状动脉图像质量明显更好（等级；优秀：SPBI 为 57.1%，SI 为 24.3%，p  = 0.03)。通过视觉评估，主动脉根部的图像质量没有显着差异。两种方法的冠状动脉和主动脉根部的信噪比 (SNR) 和对比噪声比 (CNR) 没有显着差异。SPBI 方法的访问路径显示出显着更高的 SNR（45.7 ± 11.5 对 34.3 ± 9.8，p  < 0.001）和 CNR（36.0 ± 9.7 对 28.0 ± 8.8，p  < 0.001）。与 SI 方法相比，SPBI 方法减少了 10% 的碘剂量和 45% 的辐射剂量。TAVI 前的术前 CT 成像使用 SPBI 和体积扫描是有用的，并且可以减少碘和辐射剂量。