Document Detail


Dual-source CT: effect of heart rate, heart rate variability, and calcification on image quality and diagnostic accuracy.
MedLine Citation:
PMID:  18372455     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To prospectively evaluate the effect of heart rate, heart rate variability, and calcification on dual-source computed tomography (CT) image quality and to prospectively assess diagnostic accuracy of dual-source CT for coronary artery stenosis, by using invasive coronary angiography as the reference standard. MATERIALS AND METHODS: This study had local Ethics Committee approval; all patients gave informed consent. Patients who underwent bypass surgery were excluded; patients with coronary artery stent-grafts were included. One hundred patients (20 women, 80 men; mean age, 62 years +/- 10 [standard deviation]) known to have or suspected of having coronary artery disease underwent dual-source CT and invasive coronary angiography. Image quality was assessed. Accuracy of dual-source CT in depiction or exclusion of significant stenosis (>or=50%) was evaluated on a per-segment and per-patient basis. Effects of heart rate, heart rate variability, and calcification on image quality and accuracy were analyzed by using multivariate regression and were analyzed between subgroups of predictor variables. Simple regression was performed to calculate thresholds for adequate image quality. RESULTS: Mean heart rate was 64.9 beats per minute +/- 13.2, mean variability was 23.6 beats per CT examination +/- 36.2, and mean Agatston score was 786.5 +/- 965.9. Diagnostic image quality was obtained in 90.2% of segments. Sensitivity, specificity, and positive and negative predictive values for the presence of significant stenosis were, respectively, 91.1%, 92.0%, 75.4%, and 97.5% by segment and 100%, 81.5%, 93.6%, and 100% by patient. Image quality was significantly related to heart rate variability (P = .015) and calcification (P < .001); the number of nondiagnostic segments was significantly affected by calcification only. Calcification was the single factor with significant impact on diagnostic accuracy (P = .001). CONCLUSION: While dual-source CT resulted in heart-rate independent image quality, image quality remained prone to heart rate variability and calcification.
Authors:
Harald Brodoefel; Christof Burgstahler; Ilias Tsiflikas; Anja Reimann; Stephen Schroeder; Claus D Claussen; Martin Heuschmid; Andreas F Kopp
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Publication Detail:
Type:  Journal Article     Date:  2008-03-27
Journal Detail:
Title:  Radiology     Volume:  247     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-23     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  346-55     Citation Subset:  AIM; IM    
Copyright Information:
(c) RSNA, 2008.
Affiliation:
Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str 3, 72076 Tübingen, Germany. h.brodoefel@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Calcinosis / physiopathology,  radiography*
Contrast Media
Coronary Angiography
Coronary Stenosis / physiopathology,  radiography*
Female
Heart Rate / physiology*
Humans
Iopamidol / analogs & derivatives,  diagnostic use
Isosorbide Dinitrate / administration & dosage
Male
Middle Aged
Prospective Studies
Radiographic Image Interpretation, Computer-Assisted
Regression Analysis
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Vasodilator Agents / administration & dosage
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Vasodilator Agents; 62883-00-5/Iopamidol; 78649-41-9/iomeprol; 87-33-2/Isosorbide Dinitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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