Relationship among RR interval, optimal reconstruction phase, temporal resolution, and image quality of end-systolic reconstruction of coronary CT angiography in patients with high heart rates. In search of the optimal acquisition protocol

The purpose of this study is to elucidate the relationship among RR interval (RR), the optimal reconstruction phase, and adequate temporal resolution (TR) to obtain coronary CT angiography images of acceptable quality using 64-multi detector-row CT (MDCT) (Aquilion 64) of end-systolic reconstruction in 407 patients with high heart rates. Image quality was classified into 3 groups [rank A (excellent): 161, rank B (acceptable): 207, and rank C (unacceptable): 39 patients]. The optimal absolute phase (OAP) significantly correlated with RR [OAP (ms)=119-0.286 RR (ms), r=0.832, p<0.0001], and the optimal relative phase (ORP) also significantly correlated with RR [ORP (%)=62-0.023 RR (ms), r=0.656, p<0.0001], and the correlation coefficient of OAP was significantly (p<0.0001) higher than that of ORP. The OAP range (±2 standard deviation (SD)) in which it is highly possible to get a static image was from [119-0.286 RR (ms)-46] to [119-0.286 RR (ms)+46]. The TR was significantly different among ranks A (97±22 ms), B (111±31 ms) and C (135±34 ms). The TR significantly correlated with RR in ranks A (TR=-16+0.149 RR, r=0.767, p<0.0001), B (TR=-15+0.166 RR, r=0.646, p<0.0001), and C (TR=52+0.117 RR, r=0.425, p=0.0069). Rank C was distinguished from ranks A or B by linear discriminate analysis (TR=-46+0.21 RR), and the discriminate rate was 82.6%. In conclusion, both the OAP and adequate TR depend on RR, and the OAP range (±2 SD) can be calculated using the formula [119-0.286 RR (ms)-46] to [119-0.286 RR (ms) +46], and an adequate TR value would be less than (-46+0.21 RR). (author)