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Dual-Source Versus Single-Source Cardiac CT Angiography: Comparison of Diagnostic Image Quality

¹ Department of Medicine, New York University School of Medicine, NYHHA VA Manhattan, 423 First Ave., 12 West Cardiology, New York, NY 10010.
² Department of Radiology, New York University School of Medicine, New York, NY.
³ Department of Medicine, North Shore University–Long Island Jewish Medical Center, Manhasset, NY.

OBJECTIVE. Dual-source CT improves temporal resolution, and theoretically improves the diagnostic image quality of coronary artery examinations without requiring preexamination β-blockade. The purpose of our study was to show the improved diagnostic image quality of dual-source CT compared with single-source CT despite the absence of preexamination β-blockade in the dual-source CT group.

MATERIALS AND METHODS. We performed a retrospective analysis of consecutive patients who underwent coronary artery evaluation with either single-source CT or dual-source CT at our institution between February 2005 and October 2006. Examination reports were analyzed for the presence of image artifacts, and image quality was graded on a 3-point scale (no, mild, or severe artifact). Type of artifact (motion, calcium, quantum mottle) was also noted.

RESULTS. Examinations (339 single-source CT and 126 dual-source CT) of 465 patients were analyzed. Artifact was reported in 39.8% of examinations using single-source CT and in 29.4% of examinations using dual-source CT (p < 0.05). The number of examinations with motion artifact was significantly higher with single-source CT than with dual-source CT (15.9% vs 4.8%; p < 0.001) despite significantly higher heart rates in the dual-source CT group (59.4 ± 8.4 vs 68.6 ± 14.6 beats per minute; p < 0.001). No patients in the dual-source CT group received preexamination β-blockade compared with 81% of patients in the single-source CT group. The presence of severe (nondiagnostic) calcium artifact was also significantly reduced in the dual-source CT group (13.0% vs 3.2%; p < 0.001).

CONCLUSION. Dual-source CT provides significantly better diagnostic image quality than single-source CT despite higher heart rates in the dual-source CT group. These findings support the use of dual-source CT for coronary artery imaging without the need for preexamination β-blockade.

Keywords: cardiac CT • coronary CT angiography • CT • dual-source CT • image quality

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