Examination of the optimal temporal resolution required for computed tomography coronary angiography

Sub-second multidetector-row computed tomography systems provide great potential for the further improvement of CT coronary angiography (CTCA). However, because the temporal resolution (TR) of such CT systems is insufficient, blurring and artifacts produced by fast cardiac motion remain as unresolved issues. Previous TR investigations of CTCA were based on the retrospective electrocardiogram-gated multisegment reconstruction technique. However, the results obtained may not necessarily be correct because the TR of multisegment reconstruction may not be substantial due to the insufficient periodicity of cardiac motion. The optimal TR required for better CTCA images was evaluated with use of a dual-source CT system, which has various substantial TR modes (83, 125, and 165 ms). CTCA images of 147 patients with heart rates (HRs) ranging from 36 to 117 beats/minute (bpm) were evaluated visually on a 4-point scale. Our results revealed not only that the 165-ms TR is sufficient for low HRs (≤60 bpm), but also that the 83- and 125-ms TRs are unnecessary for such HRs. The image quality with the 125-ms TR mode was acceptable for the left anterior descending artery, left circumflex artery, and right coronary artery at low to intermediate HRs (≤70 bpm). At high HRs (>70 bpm), the 83-ms TR mode resulted in an excellent image quality for all cases except those with very rapid RCA motion. Adequate TRs for a wide range of heart rates (52-106 bpm) are thus clarified.