Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd., Chaoyang District, Beijing, 100029, China.
Department of Radiology, Beijing Huairou Hospital, No. 9 Yongtai North Street, Huairou District, Beijing, 101400, China.
Eur Radiol. 2019 Aug;29(8):4215-4227. doi: 10.1007/s00330-018-5929-6. Epub 2019 Jan 7.
To assess the effect of a second-generation motion correction algorithm on the diagnostic accuracy of coronary computed tomography angiography (CCTA) using a 256-detector row CT in patients with increased heart rates.
Eighty-one consecutive symptomatic cardiac patients with increased heart rates (≥ 75 beats per min) were enrolled. All patients underwent CCTA and invasive coronary angiography (ICA). CCTA was performed with a 256-detector row CT using prospectively ECG-triggered single-beat protocol. Images were reconstructed using standard (STD) algorithm, first-generation intra-cycle motion correction (MC1) algorithm, and second-generation intra-cycle motion correction (MC2) algorithm. The image quality of coronary artery segments was assessed by two experienced radiologists using a 4-point scale (1: non-diagnostic and 4: excellent), according to the 18-segment model. Diagnostic performance for segments with significant lumen stenosis (≥ 50%) was compared between STD, MC1, and MC2 by using ICA as the reference standard.
The mean effective dose of CCTA was 1.0 mSv. On per-segment level, the overall image quality score and interpretability were improved to 3.56 ± 0.63 and 99.2% due to the use of MC2, as compared to 2.81 ± 0.85 and 92.5% with STD and 3.21 ± 0.79 and 97.2% with MC1. On per-segment level, compared to STD and MC1, MC2 improved the sensitivity (92.2% vs. 79.2%, 80.7%), specificity (97.8% vs. 82.1%, 90.8%), positive predictive value (89.9% vs. 48.4%, 65.1%), negative predictive value (98.3% vs. 94.9%, 95.7%), and diagnostic accuracy (96.8% vs. 81.5%, 89.0%).
A second-generation intra-cycle motion correction algorithm for single-beat CCTA significantly improves image quality and diagnostic accuracy in patients with increased heart rate.
• A second-generation motion correction (MC2) algorithm can further improve the image quality of all coronary arteries than a first-generation motion correction (MC1). • MC2 algorithm can significantly reduce the number of false positive segments compared to standard and MC1 algorithm.
评估第二代运动校正算法在使用 256 排 CT 对心率增快的患者进行冠状动脉 CT 血管造影（CCTA）中的诊断准确性。
连续纳入 81 例心率增快（≥75 次/分）的有症状心脏患者。所有患者均行 CCTA 和有创冠状动脉造影（ICA）。CCTA 使用前瞻性 ECG 触发单心动周期方案在 256 排 CT 上进行。使用标准（STD）算法、第一代周期内运动校正（MC1）算法和第二代周期内运动校正（MC2）算法重建图像。两位有经验的放射科医生使用 4 分制（1：无法诊断，4：优秀）根据 18 节段模型评估冠状动脉节段的图像质量。根据 ICA 作为参考标准，比较 STD、MC1 和 MC2 对有显著管腔狭窄（≥50%）的节段的诊断性能。
CCTA 的平均有效剂量为 1.0 mSv。与 STD 相比，由于 MC2 的使用，节段整体图像质量评分和可解读性分别提高至 3.56±0.63 和 99.2%，而 STD 为 2.81±0.85 和 92.5%，MC1 为 3.21±0.79 和 97.2%。与 STD 和 MC1 相比，MC2 提高了节段水平的敏感性（92.2%比 79.2%、80.7%）、特异性（97.8%比 82.1%、90.8%）、阳性预测值（89.9%比 48.4%、65.1%）、阴性预测值（98.3%比 94.9%、95.7%）和诊断准确性（96.8%比 81.5%、89.0%）。
单心动周期 CCTA 的第二代周期内运动校正算法可显著提高心率增快患者的图像质量和诊断准确性。
• 与第一代运动校正（MC1）相比，第二代运动校正（MC2）算法可进一步改善所有冠状动脉的图像质量。• MC2 算法与标准和 MC1 算法相比，可显著减少假阳性节段数。
