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Improving Diagnostic Accuracy of MDCT Coronary Angiography in Patients with Mild Heart Rhythm Irregularities Using ECG Editing

Filippo Cademartiri1,2, Nico R. Mollet1,2, Giuseppe Runza1,3, Timo Baks1,2, Massimo Midiri3, Eugene P. McFadden2, Thomas G. Flohr4, Bernd Ohnesorge4, Pim J. de Feyter1,2 and Gabriel P. Krestin1

1 Department of Radiology, Erasmus Medical Center, Dr. Molewaterplein, 40, Rotterdam 3015GD, The Netherlands.
2 Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
3 DIBIMEL, Section of Radiological Sciences, University of Palermo, Palmero, Italy.
4 Computed Tomography, Siemens Medical Solutions, Forchheim, Germany.


Figure 1
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  		Fig. 1A —Compensation of artifacts from premature beats with MDCT. Example of data set with premature beats before (A–C) and after (D–F) ECG editing obtained in 59-year-old man. ECG before editing shows three premature beats (asterisks) in background heart rate of approximately 45 beats per minute.

 

Figure 2
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  		Fig. 1B —Compensation of artifacts from premature beats with MDCT. Example of data set with premature beats before (A–C) and after (D–F) ECG editing obtained in 59-year-old man. Data set resulting from a reconstruction performed without editing shows motion artifacts at level of origin of left coronary artery (arrowheads).

 

Figure 3
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  		Fig. 1C —Compensation of artifacts from premature beats with MDCT. Example of data set with premature beats before (A–C) and after (D–F) ECG editing obtained in 59-year-old man. Data set resulting from a reconstruction performed without editing shows motion artifacts at level of origin of left coronary artery (arrowheads).

 

Figure 4
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  		Fig. 1D —Compensation of artifacts from premature beats with MDCT. Example of data set with premature beats before (A–C) and after (D–F) ECG editing obtained in 59-year-old man. After ECG editing, artifacts are ruled out and coronary vessels are assessable. Significant stenosis of proximal left anterior descending artery was missed before ECG editing (B) because of artifacts, but stenosis (arrowheads, E and F) became apparent after ECG editing.

 

Figure 5
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  		Fig. 1E —Compensation of artifacts from premature beats with MDCT. Example of data set with premature beats before (A–C) and after (D–F) ECG editing obtained in 59-year-old man. After ECG editing, artifacts are ruled out and coronary vessels are assessable. Significant stenosis of proximal left anterior descending artery was missed before ECG editing (B) because of artifacts, but stenosis (arrowheads, E and F) became apparent after ECG editing.

 

Figure 6
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  		Fig. 1F —Compensation of artifacts from premature beats with MDCT. Example of data set with premature beats before (A–C) and after (D–F) ECG editing obtained in 59-year-old man. After ECG editing, artifacts are ruled out and coronary vessels are assessable. Significant stenosis of proximal left anterior descending artery was missed before ECG editing (B) because of artifacts, but stenosis (arrowheads, E and F) became apparent after ECG editing.

 

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