Transcript The Role of MDCT scan in RVOT Ablation in BRUGADA’ s Syndrome

The Application of Multi-detector
Computed Tomography in RVOT Ablation
in BRUGADA’ s Syndrome
Paweena Mapinta R.T, Cardiac Imaging Unit , Bangkok Heart Hospital ,
Bangkok , Thailand
Background
• Radiofrequency ablation (RFA) is the effective treatment of
the right ventricular outflow tract (RVOT) tachycardia and
Brugada’s syndrome . MDCT has role in RFA planning by
demonstrating the image of the right ventricular outflow tract
(RVOT) area which is the target for ablation
• In adult patient , coronary artery disease is always the
important condition which must be assessed before ablation
operation. MDCT scanning with contrast for RVOT and for
coronary artery evaluation may be requested. Although double
CT scanning can provide all needed information but radiation
and iodinated contrast exposure dose are increased
Research Question
The newly modified technique (single scan with
iodinated contrast dose adjusting) which reduces
radiation and contrast dose exposure can be used
effectively in demonstrating the RVOT and coronary
artery comparable to the conventional technique?
Objective
• To prove that the newly modified technique which
reduces the radiation and contrast doses can be used
effectively comparable to the conventional technique
in demonstrating the RVOT and coronary artery
anatomical structure before ablation operation without
degradation of the image quality
Population and method
• 14 cases of the Brugada’s syndrome patients who
underwent MDCT scan were recruited since the year
of 2008 to 2011,12 patients were male
• The mean age of the patient was of 47.5 years old
• 12 patients were scanned by 256- slice MDCT,2
patients were scanned by 64-slice MDCT. The newly
modified technique was used for all patients
• The quality of the images obtained by the modified
technique were assessed in terms of readable and
mapping qualification by ROI of the interest area >
300 HU
Results
1. The optimum added volume of contrast using of
MDCT with the newly modified technique for
RVOT and coronary artery scanning in one
procedure is 15% of calculated contrast volume
2. MDCT using newly modified technique provided
good quality images of coronary artery and RVOT
in terms of ROI>=300 for 64.28% and readable for
100%
Conclusion
• The newly modified technique which reduces
the radiation and contrast doses can be used
successfully in demonstrating RVOT and
coronary artery before ablation operation
without degradation of the image quality
Conventional technique image
RVOT
RVOT
Aorta
Aorta
Modified technique image
RVOT
Aorta
RVOT
Aorta