Prospective versus retrospective ECG-gating for 64-detector computed tomography of the coronary venous system in pigs.
BACKGROUND
Multidetector computed tomography (MDCT) provides a non-invasive anatomic description of the coronary veins that may be useful in patients candidates to cardiac resynchronization. Prospective gating reduces radiation exposure but its impact on image quality is unknown is this setting.


OBJECTIVE
This study compared image quality and reliability of MDCT angiography of the coronary veins between prospective and retrospective gating.


METHODS
Seven anaesthetized pigs underwent 64-detector row MDCT with prospective and retrospective ECG-gating. MDCT scans were evaluated for visibility of the veins, estimated radiation dose and vein characteristics. Inter- and intra-observer reproducibility was calculated.


RESULTS
Visibility grades of all veins were significantly decreased in prospective (0.82 ± 0.6) compared to retrospective gating (1.68 ± 0.9; P<0.001), the lateral vein being missed in two cases when using prospective vs. retrospective gating. The maximal vein length was significantly increased when using retrospective gating (P=0.015). Inter-observer but not intra-observer reproducibility was dependent on the gating technique for the maximal length and contrast-to-noise ratio (P=0.003 for both). Heart rate was 82 ± 13 bpm and 86 ± 11 bpm during retrospective and prospective ECG-gating (P=ns) despite full dose of atenolol titration.


CONCLUSIONS
Retrospective gating seems to be superior to prospective gating MDCT to describe the coronary venous system but the conclusions of our study should be confined to high heart rate condition.
GIP Cyceron, Biomedical Imaging Platform, boulevard Henri-Becquerel, BP 5229, 14074 Caen cedex 5, France. roule-v@chu-caen.fr
Vincent
V
Roule
Laurent
L
Chazalviel
Alan R
AR
Young
Alain
A
Lebon
Vincent
V
Beaudouin
Denis
D
Agostini
Paul
P
Milliez
Jean-Nicolas
JN
Dacher
Alain
A
Manrique
D058671:Adrenergic beta-1 Receptor Antagonists / Q000494:pharmacology; D000818:Animals; D001262:Atenolol / Q000494:pharmacology; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D006339:Heart Rate / Q000187:drug effects; D008297:Male; D023421:Models, Animal; D061330:Multidetector Computed Tomography; D015588:Observer Variation; D010690:Phlebography / Q000379:methods*; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D015203:Reproducibility of Results; D059629:Signal-To-Noise Ratio; D013552:Swine
D058671:Adrenergic beta-1 Receptor Antagonists; D001262:Atenolol