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Image quality of 256-multidetector computed tomography in patients with atrial fibrillation: an initial experience

A series of studies on dual-source 64-multidetector computed tomography (MDCT) and 320-MDCT have demonstrated the feasibility of coronary computed tomography angiography for patients with atrial fibrillation (AF), although the examination is constrained by heart rhythm and rate. Theoretically, the newly marketed 256-MDCT (Revolution CT, GE Medical Systems, Waukesha, USA) is not limited by heart rate and rhythm, but it has not been confirmed by clinical studies. The objective of this study was to evaluate and compare the quality of 256-MDCT images obtained in patients with AF and in a control group of patients in sinus rhythm. Two reviewers were blinded to the patient groups and evaluated images of 15 coronary artery segments for each patient using 256-MDCT. The images were scored subjectively as 1 or 2, meaning of diagnostic quality, or 3, meaning poor quality. The effective doses of all patients were calculated. No statistical difference between the groups was noted in patient age (P = 0.318). The heart rates were 74.1 ± 8.5 (SD) and 66.4 ± 7.5 (SD) beats per minute in the AF group and control group, respectively, with significant difference (P = 0.004). Scores of 1 and 2 (diagnostic quality) were both assigned to 100% in sinus rhythm and AF. The overall mean image quality score for all three coronary arteries in AF was 1.12 ± 0.32 (SD) and 1.10 ± 0.28 (SD) in sinus rhythm, without significant difference (P = 0.278). The mean effective dose was 3.41 ± 1.23 (SD) and 1.91 ± 0.85 (SD) mSv in the AF and sinus rhythm groups, respectively. The analysis of our initial experience shows that the quality of all images obtained through 256-MDCT in AF patients meets the demands of diagnosis.



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