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Coronary CT Angiography with 64-MDCT: Assessment of Vessel Visibility

Harpreet K. Pannu1, Jill E. Jacobs2, Shenghan Lai3 and Elliot K. Fishman1

1 The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD; and Department of Radiology, Johns Hopkins Outpatient Center, JHOC 3235, 601 N Caroline St., Baltimore, MD 21287.
2 Department of Radiology, New York University Medical Center, New York, NY.
3 Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD.


Figure 1
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  		Fig. 1 —Coronary arteries with no motion artifact, score of 1. Oblique maximum-intensity-projection image from above heart shows left main, left anterior descending, and circumflex coronary arteries without motion artifact.

 

Figure 2
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  		Fig. 2 —Coronary arteries with minimal motion artifact, score of 2. Oblique maximum-intensity-projection image from above heart shows stairstep artifact (arrow) in circumflex coronary artery.

 

Figure 3
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  		Fig. 3A —Coronary arteries with moderate motion artifact, score of 3. Oblique maximum-intensity-projection image of first diagonal branch shows two areas of stairstep artifact (arrowheads).

 

Figure 4
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  		Fig. 3B —Coronary arteries with moderate motion artifact, score of 3. Oblique maximum-intensity-projection image of first obtuse marginal branch shows two areas of stairstep artifact (arrowheads) and minimal blurring of vessel edge (arrow).

 

Figure 5
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  		Fig. 4A —Coronary arteries with blurring of vessel due to motion artifact, score of 5. Axial maximum-intensity-projection image of right coronary artery (RCA) shows significant displacement (arrowheads) of artery due to cardiac motion.

 

Figure 6
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  		Fig. 4B —Coronary arteries with blurring of vessel due to motion artifact, score of 5. Coronal maximum-intensity-projection image of RCA shows blurring of vessel (arrows) due to motion artifact.

 

Figure 7
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  		Fig. 5A —Examples of good and poor opacification of coronary arteries. Oblique maximum-intensity-projection image of circumflex coronary artery shows good opacification.

 

Figure 8
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  		Fig. 5B —Examples of good and poor opacification of coronary arteries. Oblique maximum-intensity-projection image of circumflex coronary artery shows poor opacification.

 

Figure 9
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  		Fig. 6A —Visualization of vessels smaller than 2 mm. Axial maximum-intensity-projection image of distal right coronary artery shows posterior descending artery (arrow) is well visualized.

 

Figure 10
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  		Fig. 6B —Visualization of vessels smaller than 2 mm. Oblique maximum-intensity-projection image from above heart shows poor visualization of small first diagonal branch (arrow).

 

Figure 11
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  		Fig. 7 —Illustration shows coronary artery segments. Segments 1, 2, 3 = right coronary artery; segment 4 = right posterior descending artery; segment 11 = left main artery; segments 12, 13, 14, 15, 16 = left anterior descending artery and diagonal branches; segment 28 = ramus intermedius; segments 18, 19, 19a = circumflex artery; segment 20 = first obtuse marginal branch; segment 21 = second obtuse marginal branch; segment 29 = third diagonal branch.

 

Figure 12
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  		Fig. 8 —Bar graph shows number of assessable segments per patient for reviewer 1 (black bars) and reviewer 2 (white bars).

 

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