Initial evaluation of coronary images from 320-detector row computed tomography.
OBJECTIVE
To evaluate image quality and contrast opacification from coronary images acquired from 320-detector row computed tomography (CT). Patient dose is estimated for prospective and retrospective ECG-gating; initial correlation between 320-slice CT and coronary catheterization is illustrated.


METHODS
Retrospective image evaluation from forty consecutive patients included subjective assessment of image quality and contrast opacification (80 ml iopamidol 370 mg I/ml followed by 40 ml saline). Region of interest opacification measurements at the ostium and at 2.5 mm diameter were used to determine the gradient of contrast opacification (defined as the proximal minus distal HU measurements) in coronary arteries imaged in a single heartbeat. Estimated effective dose was compared for prospective versus retrospective ECG-gating, two body mass index categories (30 kg/m(2) cutoff), and single versus two heartbeat acquisition. When available, CT findings were correlated with those from coronary catheterization.


RESULTS
Over 89% of arterial segments (15 segment model) had excellent image quality. The most common reason for image degradation was cardiac motion. One segment in one patient was considered unevaluable. Contrast opacification was almost universally considered excellent. The mean Hounsfield units (HU) was greater than 350; the coronary contrast opacification gradient was 30-50 HU. Patient doses were greater for retrospective ECG-gating, larger patients, and those imaged with two heartbeats. For the most common (n=25) protocol (120 kV, 400 mA, prospective ECG-gating, 60-100% phase window, 16 cm craniocaudal coverage, single heartbeat), the mean dose was 6.8+/-1.4 mSv. All CT findings were confirmed in the four patients who underwent coronary catheterization.


CONCLUSIONS
Initial 320-detector row coronary CT images have consistently excellent quality and iodinated contrast opacification. These patients were scanned with conservative protocols with respect to iodine load, prospective ECG-gating phase window, and craniocaudal coverage. Future work will focus on lowering contrast and radiation dose while maintaining image quality.
Rybicki
Frank J
FJ
Noninvasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, MA 02115, USA. frybicki@partners.org
Otero
Hansel J
HJ
Steigner
Michael L
ML
Vorobiof
Gabriel
G
Nallamshetty
Leelakrishna
L
Mitsouras
Dimitrios
D
Ersoy
Hale
H
Mather
Richard T
RT
Judy
Philip F
PF
Cai
Tianxi
T
Coyner
Karl
K
Schultz
Kurt
K
Whitmore
Amanda G
AG
Di Carli
Marcelo F
MF
D000368:Aged; D006328:Cardiac Catheterization; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007479:Iopamidol