OBJECTIVES: We evaluated the influence of heart rate on image quality and diagnostic accuracy of dual-source computed tomography (DSCT) coronary angiography. BACKGROUND: Multidetector computed tomography (MDCT) coronary angiography has demonstrated an inverse relationship between heart rate and image quality. Dual-source CT provides a higher temporal resolution. METHODS: One hundred patients were studied by DSCT (DEFINITION, Siemens Medical Solutions, Forchheim, Germany). A contrast-enhanced volume dataset was acquired (two tubes, 120 kV, 400 mAs/rot, collimation 64 x 0.6 mm). Datasets were evaluated concerning the presence of significant coronary stenoses and validated against invasive coronary angiography. RESULTS: In 44 patients with a heart rate > or =65 beats/min, 566 of 616 coronary segments were evaluable (92%), whereas in 56 patients with a heart rate <65 beats/min, 777 of 778 coronary segments were evaluable (100%, p < 0.001). On a per-patient basis, 93% of patients (> or =65 beats/min) and 100% of patients (<65 beats/min) were considered evaluable. By classifying unevaluable segments as positive for stenosis, per-patient sensitivity was 95% (19 of 20) for heart rates > or =65 beats/min and 100% (22 of 22) for heart rates <65 beats/min. Specificity was 87% (21 of 24) versus 76% (26 of 34), and overall diagnostic accuracy was 91% (40 of 44) versus 86% (48 of 56). None of these differences were statistically significant. Similarly, no difference in diagnostic accuracy was found in per-vessel and -segment analyses. CONCLUSIONS: In 100 patients studied without beta-blocker pre-medication, DSCT demonstrated slightly lower per-segment evaluability for high heart rates but no decrease in diagnostic accuracy for the detection of coronary artery stenoses.
OBJECTIVES: We evaluated the influence of heart rate on image quality and diagnostic accuracy of dual-source computed tomography (DSCT) coronary angiography. BACKGROUND: Multidetector computed tomography (MDCT) coronary angiography has demonstrated an inverse relationship between heart rate and image quality. Dual-source CT provides a higher temporal resolution. METHODS: One hundred patients were studied by DSCT (DEFINITION, Siemens Medical Solutions, Forchheim, Germany). A contrast-enhanced volume dataset was acquired (two tubes, 120 kV, 400 mAs/rot, collimation 64 x 0.6 mm). Datasets were evaluated concerning the presence of significant coronary stenoses and validated against invasive coronary angiography. RESULTS: In 44 patients with a heart rate > or =65 beats/min, 566 of 616 coronary segments were evaluable (92%), whereas in 56 patients with a heart rate <65 beats/min, 777 of 778 coronary segments were evaluable (100%, p < 0.001). On a per-patient basis, 93% of patients (> or =65 beats/min) and 100% of patients (<65 beats/min) were considered evaluable. By classifying unevaluable segments as positive for stenosis, per-patient sensitivity was 95% (19 of 20) for heart rates > or =65 beats/min and 100% (22 of 22) for heart rates <65 beats/min. Specificity was 87% (21 of 24) versus 76% (26 of 34), and overall diagnostic accuracy was 91% (40 of 44) versus 86% (48 of 56). None of these differences were statistically significant. Similarly, no difference in diagnostic accuracy was found in per-vessel and -segment analyses. CONCLUSIONS: In 100 patients studied without beta-blocker pre-medication, DSCT demonstrated slightly lower per-segment evaluability for high heart rates but no decrease in diagnostic accuracy for the detection of coronary artery stenoses.
Authors: C Martini; A Palumbo; E Maffei; A Rossi; M Rengo; R Malagò; M Dijkshoorn; A Weustink; N Mollet; G Krestin; F Cademartiri Journal: Radiol Med Date: 2010-02 Impact factor: 3.469
Authors: C Martini; A Palumbo; E Maffei; A Rossi; M Rengo; R Malagò; M Dijkshoorn; A Weustink; N Mollet; G Krestin; F Cademartiri Journal: Radiol Med Date: 2009-08-07 Impact factor: 3.469
Authors: Nitesh Nerlekar; Brian S Ko; Arthur Nasis; James D Cameron; Michael Leung; Adam J Brown; Dennis T L Wong; Philip J Ngu; John M Troupis; Sujith K Seneviratne Journal: Cardiovasc Diagn Ther Date: 2017-06
Authors: Julie M Miller; Marc Dewey; Andrea L Vavere; Carlos E Rochitte; Hiroyuki Niinuma; Armin Arbab-Zadeh; Narinder Paul; John Hoe; Albert de Roos; Kunihiro Yoshioka; Pedro A Lemos; David E Bush; Albert C Lardo; John Texter; Jeffery Brinker; Christopher Cox; Melvin E Clouse; João A C Lima Journal: Eur Radiol Date: 2008-11-08 Impact factor: 5.315