Department of Radiology and Division of Cardiology, University of British Columbia, Vancouver, BC, Canada.
J Cardiovasc Comput Tomogr. 2012 May-Jun;6(3):164-71. doi: 10.1016/j.jcct.2012.04.004. Epub 2012 Apr 6.
Although coronary CT angiography (CTA) shows high diagnostic performance for detection and exclusion of obstructive coronary artery disease, limited temporal resolution of current-generation CT scanners may allow for motion artifacts, which may result in nonevaluable coronary segments.
We assessed a novel vendor-specific motion-correction algorithm for its effect on image quality and diagnostic accuracy.
Thirty-six consecutive patients with severe aortic stenosis undergoing coronary CTA without rate control and invasive coronary angiography as part of an evaluation for transcatheter aortic valve replacement. We compared image quality and diagnostic accuracy between standard (STD) and motion-corrected (MC) reconstructions. Coronary CTAs were interpreted in an intent-to-diagnose fashion by 2 experienced readers; a third reader provided consensus for interpretability and obstructive coronary stenosis (≥50% stenosis). All studies were interpreted with and without motion correction using both 45% and 75% of the R-R interval for reconstructions. Quantitative coronary angiography was performed by a core laboratory.
Mean age was 83.0 ± 6.4 years; 47% were men. Overall image quality (graded 1-4) was higher with the use of MC versus STD reconstructions (2.9 ± 0.9 vs 2.4 ± 1.0; P < 0.001). MC reconstructions showed higher interpretability on a per-segment [97% (392/406) vs 88% (357/406); P < 0.001] and per-artery [96% (128/134) vs 84% (112/134); P = 0.002] basis, with no difference on a per-patient level [92% (33/36) vs 89% (32/36); P = 1.0]. Diagnostic accuracy by MC reconstruction was higher than STD reconstruction on a per-segment [91% (370/406) vs 78% (317/406); P < 0.001] and per-artery level [86% (115/134) vs 72% (96/134); P = 0.007] basis, with no significant difference on a per-patient level [86% (31/36) vs 69% (25/36); P = 0.16].
The use of a novel MC algorithm improves image quality, interpretability, and diagnostic accuracy in persons undergoing coronary CTA without rate-control medications.
尽管冠状动脉 CT 血管造影（CTA）在检测和排除阻塞性冠状动脉疾病方面具有较高的诊断性能，但当前代 CT 扫描仪的时间分辨率有限，可能会出现运动伪影，从而导致无法评估的冠状动脉节段。
我们评估了一种新的特定于供应商的运动校正算法，以评估其对图像质量和诊断准确性的影响。
36 例因严重主动脉瓣狭窄而接受冠状动脉 CTA 检查的连续患者，且未接受心率控制药物和有创性冠状动脉造影检查，该检查是经导管主动脉瓣置换术评估的一部分。我们比较了标准（STD）和运动校正（MC）重建的图像质量和诊断准确性。由 2 名有经验的读者以意向诊断的方式对冠状动脉 CTA 进行解读；第三位读者提供了可解读性和阻塞性冠状动脉狭窄（≥50%狭窄）的共识。所有研究均在不使用和使用 MC 算法的情况下，使用 45%和 75%的 R-R 间期进行重建。由核心实验室进行定量冠状动脉造影。
平均年龄为 83.0±6.4 岁；47%为男性。与 STD 重建相比，使用 MC 重建的总体图像质量（评分为 1-4）更高（2.9±0.9 比 2.4±1.0；P<0.001）。MC 重建在节段水平[97%（392/406）比 88%（357/406）；P<0.001]和动脉水平[96%（128/134）比 84%（112/134）；P=0.002]上显示出更高的可解读性，而在患者水平上没有差异[92%（33/36）比 89%（32/36）；P=1.0]。MC 重建的诊断准确性在节段水平[91%（370/406）比 78%（317/406）；P<0.001]和动脉水平[86%（115/134）比 72%（96/134）；P=0.007]上均高于 STD 重建，而在患者水平上没有显著差异[86%（31/36）比 69%（25/36）；P=0.16]。
在未接受心率控制药物的情况下进行冠状动脉 CTA 检查的患者中，使用新的 MC 算法可提高图像质量、可解读性和诊断准确性。
