16-Slice Multi-Detector Row CT Coronary Angiography: Image Quality and Optimization of the Image Reconstruction Window

ABSTRACT

PURPOSE: The purpose of this experiment is to investigate the image quality of CT coronary angiography using a 16-slice multi-detector row CT and to determine the optimal image reconstruction window. MATERIALS AND METHODS: CT coronary angiography was obtained in 36 nonsymptomatic volunteers using a 16-slice multi-detector row CT (SOMATOM Sensation, Siemens Medical System). The mean heart rates were 70 beats per minute (bpm) or less in 18 persons and more than 70 bpm in 18 persons. Eleven data sets were obtained for each patient (reconstructed at 30-80% of the cardiac cycle with an increment of 5%). Image quality of the eight coronary segments [left main coronary artery (LM), proximal and middle segments of left anterior descending artery (p-LAD, m-LAD) and left circumflex coronary artery (p-LCx, m-LCx) and proximal, middle and distal segments of right coronary artery (p-RCA, m-RCA, d-RCA)] was assessed. RESULTS: The optimal reconstruction windows in the cardiac cycle for the best image quality were 60-70% for the segments of the LM, LAD, and LC arteries in two groups (bpm70) and 55-65% (bpm70) for the segments of the RCA. On the best dataset for each coronary segment, the following diagnostic image quality was achieved in the two groups LM 100%, 83%; p-LAD 100%, 88%; m-LAD 100%, 72%; p-LCx 100%, 72%; m-LCx 100%, 72%; p-RCA 94%, 72%; m-RCA 61%, 50%; d-RCA 100%, 88%. CONCLUSION: The 16 slice multi-detector row CT scan provided visualization of the coronary arteries with high resolution. Especially in the group with a mean heart rate of 70 bpm or less, all the coronary segments except the RCA showed diagnostic image quality. Optimal image quality was achieved with a 60-70% trigger delay for all coronary arterial segments, but the best images of RCA were achieved in the earlier cardiac phase in the patients with a mean heart rate of more than 70 bpm.