Influence of heart rate and coronary artery calcification on image quality and diagnostic performance of coronary CT angiography: comparison between 96-row detector dual source CT and 256-row multidetector CT.
BACKGROUND
CT-derived fractional flow reserve (FFRCT) and diagnostic accuracy rely on good image quality during coronary CT angiography (CCTA).


OBJECTIVE
To investigate whether heart rate (HR) and coronary artery calcium (CAC) score decrease image quality and diagnostic performance of two advanced CT scanners including 96-row detector dual source CT (DSCT) and 256-row multidetector CT (MDCT).


METHODS
First, 79 patients who underwent CCTA (42 with DSCT and 37 with MDCT) and invasive coronary angiography (ICA) are enrolled. Next, coronary segments with excellent image quality are evaluated and the percentage is calculated. Then, diagnostic accuracy in detecting significant diameter stenosis is presented with ICA as the reference standard.


RESULTS
Compared with the DSCT, the percentage of coronary segments with excellent image quality is lower (P = 0.010) while diagnostic accuracy on per-segment level is improved (P = 0.037) using MDCT. CAC score≥400 is the only independent factor influencing the percentage of coronary segments with excellent image quality [odds ratio (OR): DSCT, 3.096 and MDCT, 1.982] and segmental diagnostic accuracy (OR: DSCT, 2.630 and MDCT, 2.336) for both scanners. HR≥70 bpm (OR: 5.506) is the independent factor influencing the percentage of coronary segments with excellent image quality with MDCT.


CONCLULSION
During CCTA, CAC score≥400 still decreases the proportion of coronary segments with excellent image quality and diagnostic accuracy with advanced CT scanners. HR≥70 bpm is another factor causing image quality decreasing with MDCT.
['Qian|Wen|W|', 'Liu|Wangyan|W|', 'Zhu|Yinsu|Y|', 'Wang|Jun|J|', 'Chen|Yang|Y|', 'Meng|Haoyu|H|', 'Chen|Leilei|L|', 'Xu|Yi|Y|', 'Zhu|Xiaomei|X|']
D000072226:Computed Tomography Angiography D017023:Coronary Angiography D003331:Coronary Vessels D053805:Fractional Flow Reserve, Myocardial D006339:Heart Rate D006801:Humans D061330:Multidetector Computed Tomography
heart rate calcium Coronary angiography coronary stenosis multidetector computed tomography