Wpływ wyboru fazy bramkowania na jakość rekonstruowanych obrazów tętnic wieńcowych w wielorzędowej spiralnej tomografii komputerowej

Bibliogr. s. 63

Background: Motion artifacts caused by cardiac movement disturb the imaging of coronary arteries with multidetector-row spiral computed tomography. The aim of this study was to determine the phase of the heart rate which provides the best quality of coronary artery imaging in retrospective ECG-gated CT. Material/Methods: Forty-five cardiac CT angiograms of 26 patients were retrospectively evaluated. The examinations were performed with a 4-detector-row tomograph. ECG-gated retrospective reconstructions were relatively delayed at 0%, 12.5%, 25%, 37.5%, 50%, 62.5%, 75%, and 87.5% of the cardiac cycle. Selected coronary arteries of the highest diagnostic quality were estimated in the eight phases of the cardiac cycle. Results: Only arteries of very high image quality were selected for analysis: left coronary artery trunks (44 cases, incl. 37 stented), anterior interventricular branches (36, incl. 3 stented), circumflex branches (16), right coronary artery branches (23), and posterior interventricular branches (4). The reconstruction phase had a statistically significant impact on the quality of imaging (p < .0003). Depending on the case, optimal imaging was noted in various phases, except in the 12.5% phase. The 75% phase appeared to be the best of all those examined (p < .05), both in the group of arteries without stents (p < .0006) and in those stented (p < .05). In some cases of repeated examinations the best phases differed within the same patient. Conclusions: Although 75% is usually the best reconstruction phase, the optimal phase should be established individually for the patient, artery, segment, and type of tomograph for the best imaging quality.