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DOI:10.2214/AJR.07.3512
AJR 2008; 191:448-454
© American Roentgen Ray Society

Original Research

Dual-Source CT for Visualization of the Coronary Arteries in Heart Transplant Patients with High Heart Rates

Gorka Bastarrika1, Carlo Nicola De Cecco2, Maria Arraiza1, Stefano Mastrobuoni3, Jesús C. Pueyo1, Matias Ubilla3 and Gregorio Rábago3

1 Department of Radiology, Clínica Universitaria, Universidad de Navarra, Ave. Pío XII, 36, 31008 Pamplona, Spain.
2 Department of Radiology, Universitá di Roma Sapienza–Ospedale Sant'Andrea, Rome, Italy.
3 Department of Cardiovascular Surgery, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.

OBJECTIVE. The purpose of this study was to evaluate the quality of dual-source CT images of the coronary arteries in heart transplant recipients with high heart rates.

SUBJECTS AND METHODS. Contrast-enhanced dual-source CT coronary angiography was performed on 23 heart transplant recipients (20 men, three women; mean age, 61.1 ± 12.8 years). Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers using a 5-point scale (0, not evaluative; 4, excellent quality) assessed the quality of images of coronary segments.

RESULTS. The mean heart rate during scanning was 89.2 ± 10.4 beats/min. Interobserver agreement on the quality of images of the whole coronary tree was a kappa value of 0.78 and for selection of the optimal reconstruction interval was a kappa value of 0.82. The optimal reconstruction interval was systole in 17 (74%) of the 23 of heart transplant recipients. At the best reconstruction interval, diagnostic image quality (score ≥ 2) was obtained in 92.1% (303 of 329) of the coronary artery segments. The mean image quality score for the whole coronary tree was 3.1 ± 1.01. No significant correlation between mean heart rate ({rho} = 0.31) or heart rate variability ({rho} = 0.23) and overall image quality score was observed (p = not significant).

CONCLUSION. Dual-source CT acquisition yields coronary angiograms of diagnostic quality in heart transplant recipients. Mean heart rate and heart rate variability during scanning do not have a negative effect on the overall quality of images of the coronary arteries.

Keywords: coronary vessels • dual-source CT • heart transplantation • image quality • reconstruction interval


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