Motion artifacts on coronary CT angiography images in patients with a pericardial effusion.
BACKGROUND
Patients with a pericardial effusion can have a pendulum-like movement of the heart. No reports associate the presence of pericardial fluid with coronary CT angiography (CTA) images that are degraded by motion artifact.


OBJECTIVE
We tested the hypothesis that patients with pericardial effusion have coronary CTA images compromised by motion artifacts, even when other known causes of motion artifact in coronary imaging are minimized.


METHODS
Among the prospectively electrocardiogram-gated single heart beat 320-detector row coronary CTA studies performed from September 2009 to May 2013, 13 consecutive studies acquired with a heart rate <60 beats/min that indicate a pericardial effusion formed an effusion cohort. A control cohort included 13 studies with no pericardial fluid performed by the same CT scanner; these were pair-matched to the effusion cohort for heart rate, sex, age, and body mass index. All studies were free of arrhythmia and respiratory motion. Motion artifact was separately assessed (3-point scale) at 8 coronary segments by 2 cardiovascular imaging teams.


RESULTS
The mean pericardial effusion volume for the effusion cohort was 129 ± 57 mL (range, 39-222 mL). Intra-observer/interobserver reproducibility of the motion artifact scores were good (κ = 0.636-0.791). Motion artifacts were more frequently observed in the effusion cohort for the left circumflex (no, mild, severe artifact, 54%, 46%, 0% vs. 81%, 19%, 0%, respectively, for effusion vs. control; P = .039) and right coronary arteries (no, mild, severe artifact = 41%, 44% 15% vs. 79%, 21%, 0%, respectively, for effusion vs control; P < .001), especially for the middle or distal segments. Larger effusion volumes were associated with more severe motion artifacts.


CONCLUSIONS
Patients with pericardial effusion have coronary CTA images compromised by cardiac motion artifacts, particularly in the left circumflex and right coronary arteries.
Department of Cardiology, Takase Clinic, Takasaki 370-0036, Japan.
Takeshi
T
Kondo
Department of Cardiology, Takase Clinic, Takasaki 370-0036, Japan.
Kazuhisa
K
Takamura
Department of Cardiology, Takase Clinic, Takasaki 370-0036, Japan; Department of Cardiology, Juntendo University, Tokyo 113-8431, Japan.
Shinichiro
S
Fujimoto
Department of Cardiology, Takase Clinic, Takasaki 370-0036, Japan.
Shinichi
S
Takase
Department of Radiological Technology, Takase Clinic, Takasaki 370-0036, Japan.
Takako
T
Sekine
Department of Radiological Technology, Takase Clinic, Takasaki 370-0036, Japan.
Hideyuki
H
Matsutani
Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Frank J
FJ
Rybicki
Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA. Electronic address: kkumamaru@partners.org.
Kanako K
KK
Kumamaru
D000368:Aged; D016477:Artifacts; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D009038:Motion; D010490:Pericardial Effusion / Q000150:complications* / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
320 Multidetector CT; CT coronary angiography; Coronary artery; Motion artifact; Pericardial effusion