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1 Department of Internal Medicine II, Universität Erlangen-Nuernberg,
Ulmenweg 18, D-91054 Erlangen, Germany.
2 Institute of Diagnostic Radiology, Universität Erlangen-Nuernberg,
D-91054 Erlangen, Germany.
3 Institute of Medical Physics, Universität Erlangen-Nuernberg, D-91054
Erlangen, Germany.
OBJECTIVE. Although multidetector CT (MDCT) with retrospectively ECG-gated image reconstruction has been shown to permit noninvasive visualization of the coronary arteries, the 125-250 msec required for image acquisition frequently causes motion artifacts. We investigated the influence of a patient's heart rate on the presence of motion artifacts and on accuracy of stenosis detection on contrast-enhanced MDCT.
MATERIALS AND METHODS. In 100 patients, MDCT was performed, and ECG-gated cross-sectional images were retrospectively reconstructed. From the 10 data sets obtained for each patient (reconstructed at 0-90% of the cardiac cycle in increments of 10%), we chose the best data set for every coronary artery. The images of the arteries were evaluated for occurrence of artifacts and the presence of high-grade stenosis (diameter reduction exceeding 70%) or occlusions. MDCT results were compared with coronary angiographic findings.
RESULTS. Of the 400 coronary arteries, 115 (29%) could not be
evaluated because of motion artifacts (n = 84) or other reasons
(n = 31). Overall, 51 (49%) of 104 stenoses were revealed on MDCT.
For detecting stenosis in those arteries that we could evaluate, MDCT had a
sensitivity of 91% (51 of 56 stenoses detected) and a specificity of 89%. As
the heart rate increased, the number of arteries that could be evaluated
decreased, and overall sensitivity for stenosis detection decreased from 62%
(heart rate 
70 beats per minute) to 33% (heart rate > 70 beats per
minute).
CONCLUSION. MDCT can reveal coronary stenoses, but the usefulness of MDCT as an aid in accurately evaluating stenoses decreases as a patient's heart rate increases.
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