Prevalence of motion artifact simulating aortic dissection on spiral CT using a 180 degree linear interpolation algorithm for reconstruction of the images

Characterization of artifact simulating aortic dissection in computed tomography imaging

An artifact simulating aortic dissection has been seen in computed tomography (CT) and reported in numerous journals. The purpose of this study is to determine the origin. A phantom was constructed to simulate the motion of the ascending aorta during the cardiac cycle. Technique factors such as scan time, slice thickness, pitch, and reconstruction algorithms were examined for their effect on the simulated dissection appearance. Change in the angle of the simulated aorta with respect to the scanner axis was also studied. CT images displaying the simulated aortic dissection are obtained reproducibly. The amplitude of the artifact is more pronounced for increased scan time. The artifact amplitude is proportional to the displacement of the phantom. The simulated aortic dissection seems to be more pronounced when the scan time is comparable to the cycling time of aortic motion.

ECG-correlated imaging of the heart with subsecond multislice spiral CT

The new spiral multislice computed tomography (CT) scanners and the significant increase in rotation speed offer great potential for cardiac imaging with X-ray CT. We have therefore developed the dedicated cardiac reconstruction algorithms 180 degrees multislice cardio interpolation (MCI) and 180 degrees multislice cardio delta (MCD) and here offer further details and validation. The algorithm 180 degreesMCI is an electrocardiogram (ECG)-correlated filtering (or weighting) algorithm in both the cardiac phase and in the z-position. Effective scan times (absolute temporal resolution) of as low as t(eff) = 56 ms are possible, assuming M 4 simultaneously measured slices at a rotation time of t(rot) = 0.5 s and S < or = d < or = 3S for the table feed d per rotation, where S denotes the collimated slice thickness. The relative temporal resolution w (fraction of the heart cycle depicted in the image), which is the more important parameter in cardiac imaging, will then be as low as w = 12.5% of the heart cycle. The second approach, 180 degreesMCD, is an ECG-correlated partial scan reconstruction of 180 degrees + delta data with delta << phi (fan-angle). Its absolute temporal resolution lies in the order of 250 ms (for the central ray, i.e., for the center of rotation), and the relative temporal resolution w increases with increasing heart rate, e.g., from typically w = 25% at fH = 60 min(-1) to w = 50% at fH = 120 min(-1), assuming again t(rot) = 0.5 s. For validation purposes, we have done simulations of a virtual cardiac motion phantom, measurements of a dedicated cardiac calibration and motion phantom, and we have reconstructed patient data with simultaneously acquired ECG. Both algorithms significantly improve the image quality compared with the standard reconstruction algorithms 180 degrees multislice linear interpolation (MLI) and 180 degrees multislice filtered interpolation (MFI). However, 180 degreesMCI is clearly superior to 180 degreesMCD for all heart rates. This is best illustrated by multiplanar reformations (MPR) or other three-dimensional (3-D) displays of the volume. 180 degreesMCI, due to its higher temporal resolution, is best for spatial and temporal four-dimensional (4-D) tracking of the anatomy. A tunable scanner rotation time to avoid resonance behavior of the heart rate and the scanner's rotation and shorter rotation times would be of further benefit.

ECG-correlated image reconstruction from subsecond multi-slice spiral CT scans of the heart

Subsecond spiral computed tomography (CT) offers great potential for improving heart imaging. The new multi-row detector technology adds significantly to this potential. We therefore developed and validated dedicated cardiac reconstruction algorithms for imaging the heart with subsecond multi-slice spiral CT utilizing electrocardiogram (ECG) information. The single-slice cardiac z-interpolation algorithms 180 degrees CI and 180 degrees CD [Med. Phys. 25, 2417-2431 (1998)] were generalized to allow imaging of the heart for M-slice scanners. Two classes of algorithms were investigated: 180 degrees MCD (multi-slice cardio delta), a partial scan reconstruction of 180 degrees + delta data with a < phi (fan angle) resulting in effective scan times of 250 ms (central ray) when a 0.5 s rotation mode is available, and 180 degrees MCI (multi-slice cardio interpolation), a piecewise weighted interpolation between successive spiral data segments belonging to the same heart phase, potentially providing a relative temporal resolution of 12.5% of the heart cycle when a four-slice scanner is used and the table increment is chosen to be greater than or equal to the collimated slice thickness. Data segments are selected by correlation with the simultaneously recorded ECG signal. Theoretical studies, computer simulations, as well as patient measurements were carried out for a multi-slice scanner providing M = 4 slices to evaluate these new approaches and determine the optimal scan protocol. Both algorithms, 180 degrees MCD and 180 degrees MCI, provide significant improvements in image quality, including extremely arythmic cases. Artifacts in the reconstructed images as well as in 3D displays such as multiplanar reformations were largely reduced as compared to the standard z-interpolation algorithm 180 degrees MLI (multi-slice linear interpolation). Image quality appears adequate for precise calcium scoring and CT angiography of the coronary arteries with conventional subsecond multislice spiral CT. It turned out that for heart rates fH > or = 70 min(-1) the partial scan approach 180 degrees MCD yields unsatisfactory results as compared to 180 degrees MCI. Our theoretical considerations show that a freely selectable scanner rotation time chosen as a function of the patient's heart rate, would further improve the relative temporal resolution and thus further reduce motion artifacts. In our case an additional 0.6 s mode besides the available 0.5 s mode would be very helpful. Moreover, if technically feasible, lower rotation times such as 0.3 s or even less would result in improved image quality. The use of multi-slice techniques for cardiac CT together with the new z-interpolation methods improves the quality of heart imaging significantly. The high temporal resolution of 180 degrees MCI is adequate for spatial and temporal tracking of anatomic structures of the heart (4D reconstruction).

Helical and single-slice conventional CT versus electron beam CT for the quantification of coronary artery calcification

OBJECTIVE

We compared electron beam CT with conventional CT to determine the best method for the assessment of the coronary calcium score. We used conventional CT to examine symptomatic and asymptomatic patients suspected of having coronary artery disease.

SUBJECTS AND METHODS

One hundred sixty male patients underwent electron beam CT and helical CT with a pitch of 1 (n = 30) and 2 (n = 30) and using a single-slice mode with (n = 50) and without (n = 50) prospective ECG triggering. In another 50 patients, we determined reproducibility for repeated scanning using electron beam CT. For all images, we derived the calcium score according to the Agatston method. We performed regression analysis and determined mean variability. Mean variability was calculated as the ratio of the absolute difference to the mean of the corresponding calcium scores.

RESULTS

The correlation coefficients for electron beam CT and all conventional CT modes were very high (range, 0.93-0.98). The mean variability was highest in the helical mode with a pitch of 2 (61.4%) and lowest for the single-slice mode with prospective ECG triggering (25.4%). For repeated electron beam CT, the correlation coefficient and mean variability were 0.99 and 22.1%, respectively.

CONCLUSION

ECG-triggered single-slice conventional CT had the best agreement with electron beam CT calcium scores.

Motion artifacts of the aorta simulating aortic dissection on spiral CT

PURPOSE

Motion artifacts of the ascending aorta may impair image quality and simulate an intimal flap or a false channel. The purpose of this study is to evaluate the prevalence, amplitude, and extent of motion artifacts of the aorta in spiral CT and to specify the effects of acquisition and reconstruction parameters on these artifacts.

METHOD

One hundred seventy-one thoracic spiral CT examinations were retrospectively analyzed by two reviewers. The analysis sought to determine the presence, location, amplitude, and extent of artifacts of the ascending aorta.

RESULTS

Aortic artifacts were detected on spiral CT in 57% of cases. The mean amplitude and mean extent were 4+/-4 and 6+/-7 mm, respectively. Artifacts in the ascending aorta were significantly higher with the 360 degrees linear interpolation (LI) algorithm than with the 180 degrees LI algorithm.

CONCLUSION

The prevalence of motion artifacts on spiral CT is higher in this study than the reported prevalence in incremental CT. However, this higher prevalence is significantly reduced when the 180 degrees LI algorithm is used.