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Prospectively ECG-Triggered Sequential Dual-Source Coronary CT Angiography in Patients with Atrial Fibrillation: Influence of Heart Rate on Image Quality and Evaluation of Diagnostic Accuracy.

Yang L, Xu L, Schoepf UJ, Wichmann JL, Fox MA, Yan J, Fan Z, Zhang Z - PLoS ONE (2015)

Bottom Line: No significant impact on image quality was found for mean HR (94.9 ± 21.8 bpm; r=0.034, p=0.758; F=0.413, p=0.663) or HRV (67.5 ± 22.8 bpm; r=0.097, p=0.377; F=0.111, p=0.895).Mean effective dose was 3.3 ± 1.0 mSv.Prospectively ECG-triggered sequential dual-source CCTA provides diagnostic image quality and good diagnostic accuracy for detection of coronary stenosis in AF patients without significant influence by HR or HRV.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

ABSTRACT

Objectives: To evaluate the effects of mean heart rate (HR) and heart rate variation (HRV) on image quality and diagnostic accuracy of prospectively ECG-triggered sequential dual-source coronary CT angiography (CCTA) in patients with atrial fibrillation (AF).

Methods: Eighty-five patients (49 women, 36 men; mean age 62. 1 ± 9.5 years) with persistent AF underwent prospectively ECG-triggered sequential second-generation dual-source CCTA. Tube current and voltage were adjusted according to body mass index (BMI) and iterative reconstruction was used. Image quality of coronary segments (four-point scale) and presence of significant stenosis (>50%) were evaluated. Diagnostic accuracy was analyzed in 30 of the 85 patients who underwent additional invasive coronary angiography (ICA).

Results: Only 8 of 1102 (0.7%) segments demonstrated poor image quality. No significant impact on image quality was found for mean HR (94.9 ± 21.8 bpm; r=0.034, p=0.758; F=0.413, p=0.663) or HRV (67.5 ± 22.8 bpm; r=0.097, p=0.377; F=0.111, p=0.895). On per-segment analysis, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 89.7% (26/29), 99.4% (355/357), 92.9% (26/28), and 99.2% (355/358), respectively, with excellent correlation (kappa=0.91) with ICA. Mean effective dose was 3.3 ± 1.0 mSv.

Conclusions: Prospectively ECG-triggered sequential dual-source CCTA provides diagnostic image quality and good diagnostic accuracy for detection of coronary stenosis in AF patients without significant influence by HR or HRV.

No MeSH data available.


Related in: MedlinePlus

Prospectively ECG-triggered dual-source CCTA of a 57-year-old woman with AF.Mean HR was 100 bpm (range, 68–137 bpm). Images reconstructed at 270 msec after R wave. Volume-rendered (A) and curved multiplanar reformation (B) images of RCA (white arrow) show atherosclerosis lesion (stenosis>50%) in distal segment. Conventional coronary angiogram (C) shows significant stenosis (>50%) in distal segment of RCA (black arrow). The ECG information (D) was recorded during data acquisition.
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pone.0134194.g004: Prospectively ECG-triggered dual-source CCTA of a 57-year-old woman with AF.Mean HR was 100 bpm (range, 68–137 bpm). Images reconstructed at 270 msec after R wave. Volume-rendered (A) and curved multiplanar reformation (B) images of RCA (white arrow) show atherosclerosis lesion (stenosis>50%) in distal segment. Conventional coronary angiogram (C) shows significant stenosis (>50%) in distal segment of RCA (black arrow). The ECG information (D) was recorded during data acquisition.

Mentions: The sensitivity, specificity, PPV, and NPV values of CCTA are shown in Table 4. On a per-segment basis, three vessel segments with poor image quality on CCTA were ruled out due to the calculation of diagnostic accuracy. The sensitivity, specificity, PPV, and NPV for CCTA were 89.7%, 99.4%, 92.9%, and 99.2%, respectively. On a per-vessel basis, they were 83.3%, 97.0%, 90.9%, 94.1%, respectively, and on a per-patient basis, they were 81.8%, 94.7%, 90.0%, and 90.0%, respectively. There was good to excellent intermodality agreement between CCTA and ICA in terms of detection of significant stenosis (κ = 0.91, 0.83, 0.78) (Table 4, Figs 3 and 4).


Prospectively ECG-Triggered Sequential Dual-Source Coronary CT Angiography in Patients with Atrial Fibrillation: Influence of Heart Rate on Image Quality and Evaluation of Diagnostic Accuracy.

Yang L, Xu L, Schoepf UJ, Wichmann JL, Fox MA, Yan J, Fan Z, Zhang Z - PLoS ONE (2015)

Prospectively ECG-triggered dual-source CCTA of a 57-year-old woman with AF.Mean HR was 100 bpm (range, 68–137 bpm). Images reconstructed at 270 msec after R wave. Volume-rendered (A) and curved multiplanar reformation (B) images of RCA (white arrow) show atherosclerosis lesion (stenosis>50%) in distal segment. Conventional coronary angiogram (C) shows significant stenosis (>50%) in distal segment of RCA (black arrow). The ECG information (D) was recorded during data acquisition.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4519310&req=5

pone.0134194.g004: Prospectively ECG-triggered dual-source CCTA of a 57-year-old woman with AF.Mean HR was 100 bpm (range, 68–137 bpm). Images reconstructed at 270 msec after R wave. Volume-rendered (A) and curved multiplanar reformation (B) images of RCA (white arrow) show atherosclerosis lesion (stenosis>50%) in distal segment. Conventional coronary angiogram (C) shows significant stenosis (>50%) in distal segment of RCA (black arrow). The ECG information (D) was recorded during data acquisition.
Mentions: The sensitivity, specificity, PPV, and NPV values of CCTA are shown in Table 4. On a per-segment basis, three vessel segments with poor image quality on CCTA were ruled out due to the calculation of diagnostic accuracy. The sensitivity, specificity, PPV, and NPV for CCTA were 89.7%, 99.4%, 92.9%, and 99.2%, respectively. On a per-vessel basis, they were 83.3%, 97.0%, 90.9%, 94.1%, respectively, and on a per-patient basis, they were 81.8%, 94.7%, 90.0%, and 90.0%, respectively. There was good to excellent intermodality agreement between CCTA and ICA in terms of detection of significant stenosis (κ = 0.91, 0.83, 0.78) (Table 4, Figs 3 and 4).

Bottom Line: No significant impact on image quality was found for mean HR (94.9 ± 21.8 bpm; r=0.034, p=0.758; F=0.413, p=0.663) or HRV (67.5 ± 22.8 bpm; r=0.097, p=0.377; F=0.111, p=0.895).Mean effective dose was 3.3 ± 1.0 mSv.Prospectively ECG-triggered sequential dual-source CCTA provides diagnostic image quality and good diagnostic accuracy for detection of coronary stenosis in AF patients without significant influence by HR or HRV.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

ABSTRACT

Objectives: To evaluate the effects of mean heart rate (HR) and heart rate variation (HRV) on image quality and diagnostic accuracy of prospectively ECG-triggered sequential dual-source coronary CT angiography (CCTA) in patients with atrial fibrillation (AF).

Methods: Eighty-five patients (49 women, 36 men; mean age 62. 1 ± 9.5 years) with persistent AF underwent prospectively ECG-triggered sequential second-generation dual-source CCTA. Tube current and voltage were adjusted according to body mass index (BMI) and iterative reconstruction was used. Image quality of coronary segments (four-point scale) and presence of significant stenosis (>50%) were evaluated. Diagnostic accuracy was analyzed in 30 of the 85 patients who underwent additional invasive coronary angiography (ICA).

Results: Only 8 of 1102 (0.7%) segments demonstrated poor image quality. No significant impact on image quality was found for mean HR (94.9 ± 21.8 bpm; r=0.034, p=0.758; F=0.413, p=0.663) or HRV (67.5 ± 22.8 bpm; r=0.097, p=0.377; F=0.111, p=0.895). On per-segment analysis, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 89.7% (26/29), 99.4% (355/357), 92.9% (26/28), and 99.2% (355/358), respectively, with excellent correlation (kappa=0.91) with ICA. Mean effective dose was 3.3 ± 1.0 mSv.

Conclusions: Prospectively ECG-triggered sequential dual-source CCTA provides diagnostic image quality and good diagnostic accuracy for detection of coronary stenosis in AF patients without significant influence by HR or HRV.

No MeSH data available.


Related in: MedlinePlus