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Coronary CT angiography with 64-MDCT: assessment of vessel visibility
Harpreet K Pannu1, Jill E Jacobs, Shenghan Lai
1The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Insights
Sixty-four-multi-detector row computed tomography (64-MDCT) coronary angiography provides high-quality imaging. This study found 89% of coronary artery segments assessable, with 94% of patients having at least 10 assessable segments.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Coronary angiography is crucial for diagnosing coronary artery disease.
- Multi-detector row computed tomography (MDCT) offers advanced imaging capabilities for cardiac assessment.
Purpose of the Study:
- To evaluate the diagnostic image quality of 64-MDCT for coronary angiography.
- To determine the assessability of coronary artery segments using 64-MDCT.
Main Methods:
- Fifty CT coronary angiograms from a 64-MDCT scanner were reviewed by two independent readers.
- Coronary artery segments were scored for motion artifact, opacification, and visibility.
- Assessability was determined based on motion scores, opacification, and visibility, with specific criteria for segments < 2 mm.
Main Results:
- 89.2% of analyzed coronary artery segments (637 out of 714) were deemed assessable.
- In 94% of patients (47 out of 50), 10 or more coronary vessel segments were assessable.
- High rates of good opacification (average score 1.02) and minimal motion (average score 1) were observed.
Conclusions:
- 64-MDCT provides excellent image quality for coronary angiography.
- The majority of coronary artery segments are assessable, ensuring comprehensive diagnostic information.
- This technique is highly effective for per-patient coronary artery assessment.
Objective:
The objective of our study was to evaluate the image quality of 64-MDCT for coronary angiography.
Subjects And Methods:
Fifty consecutive CT coronary angiograms obtained on a 64-MDCT scanner were independently reviewed by two reviewers. Segments were scored as showing no motion (score of 1), minimal motion (2), moderate motion (3), respiratory motion (4), or vessel blurring (5). Opacification was graded as good (score of 1) or limited (2). Segments < 2 mm were graded as well seen; or as poorly seen or not seen. The scores for motion artifact, opacification, and visibility were combined for overall vessel assessment. Segments with a motion score of 1 or 2 that had good opacification and were well seen were judged to be assessable.
Results:
A total of 714 segments were analyzed in 50 patients. Seven hundred segments were assessed in all patients (segments 1-3, 11-20, 4, or 27), and a ramus intermedius segment was evaluated in 14 patients. Combining the scores for both reviewers, the average motion score was 1 for 619 segments (86.7%), the average motion score for all segments in an individual patient was 1.14 (range, 1-3.35), and the average opacification score for all segments in a patient was 1.02 (range, 1-1.38). A total of 374 segments were less than 2 mm in diameter. Combining the scores for both reviewers, an average of 36 segments (5.0% of 714) could not be identified by the reviewers, 319.5 segments (85.4%) were well seen, and 18.5 segments (4.9%) were poorly seen. Overall, an average of 637 segments (89.2%) were judged assessable by the reviewers. On a per-patient basis, 10 or more vessel segments were judged assessable in 47 patients (94%).
Conclusion:
On 64-MDCT, 89% of coronary artery segments are assessable. Ten or more vessel segments are assessable in 94% of patients.
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