Analysis of Image Quality and Optimized Reconstruction Window through Heart Rate and Its Variation in Retrospectively ECG-gated Coronary Angiography Using Multi-Detector Row CT

Image quality and selection of optimized window for good quality reconstruction in coronary angiography using multi-detector row CT (MDCT) have not been studied by heart rate and its variation. Therefore, the effect of heart rate and its variation was systemically analyzed. Eighty-three patients were undergone contrast-enhanced coronary angiography using MDCT. In this study, sixty cases were enrolled. Two radiologists graded image quality as follows: 4, excellent; 3, good; 2, fair; l, bad. The starting points of the reconstruction window were chosen at seventy and forty percent of R wave interval. Optimized window was scored as 1 when 40% reconstruction was better quality than 70%, as 2 when 40% reconstruction is same as 70%, and as 3 when 70% reconstruction was better than 40%. Regression analysis was performed. The range of variation of beats per minute (BPM) was well correlated with image quality (r=-0.55, p=0.000), however correlation with optimized window percentage was not statistically significant (p=0.969). By contraries, median value of BPM was comparatively well correlated with optimized window grade (r=-0.24, p=0.086). Median value of BPM was not well correlated with image quality (r=0.l70, p=0.l97). Image quality is more affected by variation of heart rate (VHR) than by higher heart rate. Selection of optimized reconstruction window for good image quality is mainly affected by heart rate and there is a tendency that systolic phase reconstruction is better in image quality than diastolic reconstruction in higher heart rate.