Optimal electrocardiographic pulsing windows and heart rate: effect on image quality and radiation exposure at dual-source coronary CT angiography

Radiology
Annick C WeustinkGabriel P Krestin

Abstract

To determine the optimal width and timing of the electrocardiographic (ECG) pulsing window within the cardiac cycle in relation to heart rate (HR), image quality, and radiation exposure in patients who are suspected of having coronary artery disease. The institutional review board approved the study, and all patients gave informed consent. Dual-source computed tomography (CT) was performed in 301 patients (mean HR, 70.1 beats per minute +/- 13.3 [standard deviation]; range, 43-112 beats per minute) by using a wide ECG pulsing window (25%-70% of the R-R interval). Data sets were reconstructed in 5% steps from 20%-75% of R-R interval. Image quality was assessed by two observers on a per-segment level and was classified as good or impaired. High-quality data sets were those in which each segment was of good quality. The width and timing of the image reconstruction window was calculated. On the basis of these findings, an optimal HR-dependent ECG pulsing protocol was designed, and the potential dose-saving effect on effective dose (in millisieverts) was calculated. At low HR (< or = 65 beats per minute), high-quality data sets were obtained during end diastole (ED); at high HR (> or = 80 beats per minute), they were obtained during...Continue Reading

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Nov 30, 2010·Der Radiologe·N Glaser-GallionS Leschka
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