ObjectiveTo prospectively investigate the diagnostic accuracy, image quality, and radiation doses of electrocardiogram (ECG)-triggered high-pitch acquisition (turbo flash) coronary computed tomography(CT) angiography(CCTA) using third-generation dual-source CT compared with coronary angiography(CAG) for the diagnosis of significant coronary stenoses.

MethodsProspectively collected 1003 patients who received the third-generation dual-source CCTA examination from April 2016 to April 2017. Among them, 70 patients underwent coronary angiography(CAG) 30 days after CCTA examination to score the image quality of each segment of coronary artery and calculate the effective radiation dose. The sensitivity, specificity, positive predictive value and negative predictive value of CCTA for coronary artery lesions were calculated using CAG results as the gold standard. The consistency of CCTA and CAG in grading coronary artery stenosis was evaluated by Kappa value and U test.

Results(1) Image quality:no non-diagnostic image quality was observed in the right coronary artery nor left anterior descending artery. The rate of coronary segments with non-diagnostic image quality reached 0.04% in the left circumflex artery. (2) Diagnostic accuracy:the sensitivity, specificity, and positive and negative predictive values totaled 97.0%(289/298), 98.3%(706/718), 96.0%(289/301), 98.7%(706/715) for segment assessment and 97.5%(159/163), 85.1% (40/47), 95.8%(159/166), 90.9%(40/44) for vessel assessment, and all the values are 100% for patients assessment. CCTA was highly consistent with the site of coronary artery stenosis shown by CAG(U=2.4, P < 0.05). ⑶ Radiation doses:the effective radiation dose was(1.17±0.29) mSv on average.

ConclusionsCCTA using the prospectively ECG-triggered high-pitch mode (turbo flash) of the third-generation dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenoses at low doses.