| Predictors of image quality of coronary computed tomography in the acute care setting of patients with chest pain. | |
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MedLine Citation:
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PMID: 19346094 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We aimed to determine predictors of image quality in consecutive patients who underwent coronary computed tomography (CT) for the evaluation of acute chest pain. METHOD AND MATERIALS: We prospectively enrolled patients who presented with chest pain to the emergency department. All subjects underwent contrast-enhanced 64-slice coronary multi-detector CT. Two experienced readers determined overall image quality on a per-patient basis and the prevalence and characteristics of non-evaluable coronary segments on a per-segment basis. RESULTS: Among 378 subjects (143 women, age: 52.9+/-11.8 years), 345 (91%) had acceptable overall image quality, while 33 (9%) had poor image quality or were unreadable. In adjusted analysis, patients with diabetes, hypertension and a higher heart rate during the scan were more likely to have exams graded as poor or unreadable (odds ratio [OR]: 2.94, p=0.02; OR: 2.62, p=0.03; OR: 1.43, p=0.02; respectively). Of 6253 coronary segments, 257 (4%) were non-evaluable, most due to severe calcification in combination with motion (35%). The presence of non-evaluable coronary segments was associated with age (OR: 1.08 annually, 95%-confidence interval [CI]: 1.05-1.12, p<0.001), baseline heart rate (OR: 1.35 per 10 beats/min, 95%-CI: 1.11-1.67, p=0.003), diabetes, hypertension, and history of coronary artery disease (OR: 4.43, 95%-CI: 1.93-10.17, p<0.001; OR: 2.27, 95-CI: 1.01-4.73, p=0.03; OR: 5.12, 95%-CI: 2.0-13.06, p<0.001; respectively). CONCLUSION: Coronary CT permits acceptable image quality in more than 90% of patients with chest pain. Patients with multiple risk factors are more likely to have impaired image quality or non-evaluable coronary segments. These patients may require careful patient preparation and optimization of CT scanning protocols. |
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Authors:
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Fabian Bamberg; Suhny Abbara; Christopher L Schlett; Ricardo C Cury; Quynh A Truong; Ian S Rogers; John T Nagurney; Thomas J Brady; Udo Hoffmann |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2009-04-05 |
Journal Detail:
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Title: European journal of radiology Volume: 74 ISSN: 1872-7727 ISO Abbreviation: Eur J Radiol Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-05 Completed Date: 2010-08-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8106411 Medline TA: Eur J Radiol Country: Ireland |
Other Details:
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Languages: eng Pagination: 182-8 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Cardiac MR PET CT Program, Department of Radiology and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Chest Pain
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radiography* Coronary Angiography / methods* Female Humans Male Middle Aged Predictive Value of Tests Radiographic Image Interpretation, Computer-Assisted Tomography, X-Ray Computed / methods* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL080053/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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