Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT.
BACKGROUND
We investigated the applicability and image quality of contrast-enhanced coronary artery visualization by multislice spiral CT using retrospective ECG gating.


RESULTS
Twenty-five patients in sinus rhythm (significant coronary artery stenoses ruled out by invasive angiography) were studied with a multislice spiral CT (Siemens SOMATOM Volume Zoom). In inspiration (mean breath-hold, 37 seconds), a volume data set of the heart was acquired (intravenous contrast agent; 4 x 1-mm slice thickness; 500-ms rotation; table feed, 1.5 mm/360 degrees ). Simultaneous recording of the ECG permitted retrospective reconstruction of contiguous cross sections in intervals of 1 mm at any desired interval of the cardiac cycle. The mean duration of the image reconstruction window was 185 ms. Next to 3-dimensional reconstructions of the heart and coronary arteries, multiplanar reconstructions were rendered to determine the visualized length of the coronary arteries, the contrast-to-noise ratio, and the correlation of coronary artery diameters to quantitative coronary angiography.


CONCLUSIONS
The coronary arteries could be visualized over long segments (left main, 9+/-4 mm; left anterior descending, 112+/-34 mm; left circumflex, 80+/-29 mm; right coronary artery, 116+/-33 mm). On average, 78+/-16% of these distances were visualized free of motion artifacts. The mean contrast-to-noise ratio was 9.3+/-3.3. Coronary artery diameters in multislice spiral CT showed close correlation to quantitative coronary angiography (CT, 3.3+/-1.0 mm; angiography, 3. 2+/-0.9 mm; mean difference, 0.38 mm; r=0.86). Contrast-enhanced multislice spiral CT permits visualization of the coronary artery lumen. Further studies are necessary to determine whether image quality is sufficient to reliably detect coronary artery stenoses.
Achenbach
S
S
Department of Internal Medicine II, University of Erlangen-Nürnberg, Germany. stephan.achenbach@rzmail.uni-erlangen.de
Ulzheimer
S
S
Baum
U
U
Kachelriess
M
M
Ropers
D
D
Giesler
T
T
Bautz
W
W
Daniel
W G
WG
Kalender
W A
WA
Moshage
W
W
D000328:Adult; D000368:Aged; D000465:Algorithms; D001835:Body Weight; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods* / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000175:diagnosis; D003331:Coronary Vessels / Q000033:anatomy & histology*; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006321:Heart / Q000033:anatomy & histology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data
D003287:Contrast Media