Journal List > J Korean Med Assoc > v.50(2) > 1041841

Lee: Technical Aspect of Coronary CT Angiography : Imaging Tips and Safety Issues

Abstract

CT coronary angiography is popular nowadays because of the wide use of multidetector CT. Multidetector CT has an isotropic resolution at 0.3~0.4 mm and temporal resolution at 80~210 ms. With the retrospective EKG-gated reconstruction technique and these high spatial and temporal resolutions, coronary artery imaging is possbile with CT. EKG-gated CT consists of EKG recording and continuous CT scanning with a low-pitch value. The CT data from certain periods of cardiac cycles, in which the cardiac motion is minimal, are retrospectively selected and reconstructed to whole heart volume data, and then the motion freezing entire heart CT image can be obtained. Because of its limited temporal resolution, EKG-gated CT requires lowering of the heart rate by beta-blocker medication in most cases. The lower heart rate increases diagnostic accuracy of coronary CT angiography. The nitroglycerin can also be used for coronary artery dilatation. Coronary CT angiography is a very reliable method for evaluating coronary artery stenosis with a noninvasive manner. The potential hazard comes from the use of ionized radiation and iodine contrast media. The typical radiation dose for coronary CT angiography is reported as 6.7~13.0mSv. This radiation dose is equivalent to those for other noninvasive coronary artery evaluating tools with radioactive isotopes and higher than the dose for conventional coronary angiography.

References

1. Lu B, Zhuang N, Mao SS, Bakhsheshi H, Liu SC, Budoff MJ. Image quality of three-dimensional electron beam coronary angiography. J Comput Assist Tomogr. 2002. 26:202–209.
crossref
2. Ohnesorge B, Flohr T, Becker C, Kopp AF, Schoepf UJ, Baum U, Knez A, Klingenbeck-Regn K, Reiser MF. Cardiac imaging by means of electrocardiographically gated multisection spiral CT: initial experience. Radiology. 2000. 217:564–571.
crossref
3. Nieman K, Cademartiri F, Lemos PA, Raaijmakers R, Pattynama PM, de Feyter PJ. Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation. 2002. 106:2051–2054.
crossref
4. Scheffel H, Alkadhi H, Plass A, Vachenauer R, Desbiolles L, Gaemperli O, Schepis T, Frauenfelder T, Schertler T, Husmann L, Grunenfelder J, Genoni M, Kaufmann PA, Marincek B, Leschka S. Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control. Eur Radiol. 2006. 16:2739–2747.
crossref
5. Kondo C, Mori S, Endo M, Kusakabe K, Suzuki N, Hattori A, Kusakabe M. Real-time volumetric imaging of human heart without electrocardiographic gating by 256-detector row computed tomography: initial experience. J Comput Assist Tomogr. 2005. 29:694–698.
crossref
6. Mori S, Kondo C, Suzuki N, Yamashita H, Hattori A, Kusakabe M, Endo M. Volumetric cine imaging for cardiovascular circulation using prototype 256-detector row computed tomography scanner (4-dimensional computed tomography): a preliminary study with a porcine model. J Comput Assist Tomogr. 2005. 29:26–30.
crossref
7. Achenbach S, Ropers D, Holle J, Muschiol G, Daniel WG, Moshage W. In-plane coronary arterial motion velocity: measurement with electron-beam CT. Radiology. 2000. 216:457–463.
crossref
8. Kuettner A, Kopp AF, Schroeder S, Rieger T, Brunn J, Meisner C, Heuschmid M, Trabold T, Burgstahler C, Martensen J, Schoebel W, Selbmann HK, Claussen CD. Diagnostic accuracy of multidetector computed tomography coronary angiography in patients with angiographically proven coronary artery disease. J Am Coll Cardiol. 2004. 43:831–839.
crossref
9. Kuettner A, Beck T, Drosch T, Kettering K, Heuschmid M, Burgstahler C, Claussen CD, Kopp AF, Schroeder S. Diagnostic accuracy of noninvasive coronary imaging using 16detector slice spiral computed tomography with 188 ms temporal resolution. J Am Coll Cardiol. 2005. 45:123–127.
crossref
10. Hoffmann U, Moselewski F, Cury RC, Ferencik M, Jang IK, Diaz LJ, Abbara S, Brady TJ, Achenbach S. Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease: patient-versus segment-based analysis. Circulation. 2004. 110:2638–2643.
crossref
11. Hunold P, Vogt FM, Schmermund A, Debatin JF, Kerkhoff G, Budde T, Erbel R, Ewen K, Barkhausen J. Radiation exposure during cardiac CT: effective doses at multi-detector row CT and electron-beam CT. Radiology. 2003. 226:145–152.
crossref
12. Donnelly PM, Higginson JD, Hanley PD. Multidetector CT coronary angiography: have we found the holy grail of non-invasive coronary imaging? Heart. 2005. 91:1385–1388.
crossref
13. Abada HT, Larchez C, Daoud B, Sigal-Cinqualbre A, Paul JF. Multislice CT of the coronary arteries: feasibility of low-dose CT with ECG-pulsed tube current modulation to reduce radiation dose. Am J Roentgenol. 2006. 186:S387–S390.
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