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High-pitch coronary CT angiography with third generation dual-source CT: limits of heart rate

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Abstract

To determine the average heart rate (HR) and heart rate variability (HRV) required for diagnostic imaging of the coronary arteries in patients undergoing high-pitch CT-angiography (CTA) with third-generation dual-source CT. Fifty consecutive patients underwent CTA of the thoracic (n = 8) and thoracoabdominal (n = 42) aorta with third-generation dual-source 192-slice CT with prospective electrocardiography (ECG)-gating at a pitch of 3.2. No β-blockers were administered. Motion artifacts of coronary arteries were graded on a 4-point scale. Average HR and HRV were noted. The average HR was 66 ± 11 beats per minute (bpm) (range 45–96 bpm); the HRV was 7.3 ± 4.4 bpm (range 3–20 bpm). Interobserver agreement on grade of image quality for the 642 coronary segments evaluated by both observers was good (κ = 0.71). Diagnostic image quality was found for 608 of the 642 segments (95 %) in 43 of 50 patients (86 %). In 14 % of the patients, image quality was nondiagnostic for at least one segment. HR (p = 0.001) was significantly higher in patients with at least one non-diagnostic segment compared to those without. There was no significant difference (p > 0.05) in HRV between patients with nondiagnostic segments and those with diagnostic images of all segments. All patients with a HR < 70 bpm had diagnostic image quality in all coronary segments. The effective radiation dose and scan time for the heart were 0.4 ± 0.1 mSv and 0.17 ± 0.02 s, respectively. Third-generation dual-source 192-slice CT allows for coronary angiography in the prospectively ECG-gated high-pitch mode with diagnostic image quality at HR up to 70 bpm. HRV is not significantly related to image quality of coronary CTA.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Sonja Gordic, Daniela B. Husarik, Lotus Desbiolles, Sebastian Leschka, Thomas Frauenfelder & Hatem Alkadhi

  2. Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland

    Lotus Desbiolles & Sebastian Leschka

Authors
  1. Sonja Gordic
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  2. Daniela B. Husarik
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  3. Lotus Desbiolles
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  4. Sebastian Leschka
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  5. Thomas Frauenfelder
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  6. Hatem Alkadhi
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Correspondence to Hatem Alkadhi.

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Gordic, S., Husarik, D.B., Desbiolles, L. et al. High-pitch coronary CT angiography with third generation dual-source CT: limits of heart rate. Int J Cardiovasc Imaging 30, 1173–1179 (2014). https://doi.org/10.1007/s10554-014-0445-5

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  • DOI: https://doi.org/10.1007/s10554-014-0445-5

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