Abstract
To evaluate the benefits regarding image quality and radiation dose of new generation 256 Multi-Detector CT (MDCT) for CCTA in patients with a high heart rate (HR). Hundred consecutive patients with a HR >65bpm were retrospectively included (50 patients on a 64-MDCT, group A, 73.9±7.5 bpm; 50 patients on a 256-MDCT, group B, 85.8±30.0bpm). Prevalence and impact on diagnosis of motion and step artifacts were evaluated by two experienced readers using a 3-point scale (0: no artifact; 1: artifacts without interference on diagnosis; 2: artifacts interfere with diagnosis) and percentage of assessable coronary segments was calculated. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were measured for quantitative assessment. Radiation dose was evaluated by calculating the mean effective dose (ED). In group B, motion artefacts were significantly reduced (0.58±0.64 vs 1.37±0.72, p<0.001) and no step artifact was observed (vs. 0.98±0.79, p<0.001). That resulted in a significant improvement in coronary segments assessability in group B (98.6% vs 80.9%, p<0.001). Both mean CNR and mean SNR were increased by 20% (p<0.001) in group B and ED was reduced by 82% (14.9±4.9 vs. 2.7±1.9 mSv p<0.001). New generation 256-MDCT allows performing pure arterial CCTA on high heart rate patients with improved image quality and coronary segments assessability, and reduced radiation dose.
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