Wintersperger Bernd J, Nikolaou Konstantin, von Ziegler Franz, Johnson Thorsten, Rist Carsten, Leber Alexander, Flohr Thomas, Knez Andreas, Reiser Maximilian F, Becker Christoph R
Department of Clinical Radiology, University Hospitals-Grosshadern, Germany.
Invest Radiol. 2006 May;41(5):436-42. doi: 10.1097/01.rli.0000202639.99949.c6.
We sought to evaluate the impact of patients' heart rate (HR) on coronary CTA image quality (IQ) and motion artifacts using a 64-slice scanner with 0.33/360 degrees rotation.
Coronary CTA data sets of 32 patients (HR <or= 65 beats per minute [bpm], n = 15; HR > 65 bpm to <or=75 bpm, n = 10; HR > 75 bpm, n = 7) examined on a 64-slice scanner (Sensation 64, Siemens Medical Solutions, Forchheim, Germany) with 0.33s/360 degrees gantry rotation speed were analyzed. All patients had suspicion of coronary artery disease. Data acquisition was performed using 64 x 0.6-mm collimation, and contrast enhancement was provided by injection of 80 mL of iopromide (5 mL/s + NaCl). Images were reconstructed throughout the RR interval using half-scan and dual-segment reconstruction. IQ was rated by 2 observers using a 3-point scale from excellent (1) to nondiagnostic (3) for coronary segments. Quality was correlated to the HR, time point of optimal IQ analyzed, and the benefit of dual-segment reconstruction evaluated.
Overall mean IQ was 1.31 +/- 0.32 for all HR, with IQ being 1.08 +/- 0.12 for HR <or= 65 bpm, 1.62 +/- 0.27 for HR > 65 bpm <or= 75 bpm and 1.36 +/- 0.31 for HR > 75 bpm (P = 0.0003). Dual-segment reconstruction did not significantly improve IQ in any HR group (P = NS). Mean IQ was significantly better for LAD than for RCA (P < 0.0001) and LCX (P < 0.01). A total of 3.5% (11/318) of coronary artery segments were rated nondiagnostic by at least one reader based on motion artifacts. Although in HR < 65 bpm, the best IQ was predominately in diastole (93%), in HR > 75 bpm, the best IQ shifted to systole in most cases (86%).
Temporal resolution at 0.33-second rotation allows for diagnostic IQ within a wide range of HR using half-scan reconstruction. With increasing HR the time point of best IQ shifts from mid-diastole to systole.
我们试图使用一台旋转速度为0.33/360度的64层扫描仪,评估患者心率(HR)对冠状动脉CT血管造影(CTA)图像质量(IQ)和运动伪影的影响。
分析了32例患者(心率≤65次/分钟[bpm],n = 15;心率> 65 bpm至≤75 bpm,n = 10;心率> 75 bpm,n = 7)在一台旋转速度为0.33秒/360度的64层扫描仪(西门子医疗解决方案公司的Sensation 64,德国福希海姆)上进行冠状动脉CTA检查的数据。所有患者均怀疑患有冠状动脉疾病。采用64×0.6毫米的准直进行数据采集,并通过注射80毫升碘普罗胺(5毫升/秒+氯化钠)实现对比增强。在整个RR间期使用半扫描和双段重建技术重建图像。由2名观察者使用从优(1)到非诊断性(3)的3分制对冠状动脉节段的图像质量进行评分。将图像质量与心率、分析得出的最佳图像质量时间点以及双段重建的益处进行相关性分析。
所有心率情况下的总体平均图像质量为1.31±0.32,心率≤65 bpm时图像质量为1.08±0.12,心率> 65 bpm至≤75 bpm时为1.62±0.27,心率> 75 bpm时为1.36±0.31(P = 0.0003)。双段重建在任何心率组中均未显著改善图像质量(P =无显著性差异)。左前降支(LAD)的平均图像质量显著优于右冠状动脉(RCA)(P < 0.0001)和左旋支(LCX)(P < 0.01)。基于运动伪影,至少有一名读者将3.5%(11/318)的冠状动脉节段评为非诊断性。尽管在心率< 65 bpm时,最佳图像质量主要出现在舒张期(93%),但在心率> 75 bpm时,大多数情况下最佳图像质量转移到了收缩期(86%)。
0.33秒旋转的时间分辨率允许使用半扫描重建技术在较宽的心率范围内获得诊断性图像质量。随着心率增加,最佳图像质量的时间点从舒张中期转移到收缩期。