![]() Less frequent causes were motion artifacts and obesity resulting in a poor contrast-to-noise ratio. False-positive and false-negative interpretations were attributed to image artifacts in 91% to 100% of cases, where the major cause was the presence of calcifications. Interestingly, of the coronary artery segments that were included in 64-MDCT studies, the accuracy for detecting stenoses depended highly on image artifacts. Moreover, these study results should be interpreted with care because coronary artery segments that could not be evaluated (3-27%) were excluded from analysis beforehand. However, these study outcomes are difficult to compare because the study methods vary substantially-for example, in the selection of patients. Sensitivities and specificities for detecting significant ( 3 50%) coronary artery stenoses based on segmental analysis with 64-MDCT (conventional X-ray coronary angiography as the standard of reference) have been found to be good to excellent, in the range of 76-99% and 95-97%, respectively. With 64-MDCT, 3-11% of coronary artery segments still cannot be evaluated. One study stated that if these segments that could not be evaluated were excluded or considered negative, 25% of patients with a significant stenosis would have been missed. With 16-MDCT, 22-29% of the coronary artery segments could not be evaluated. With 4-MDCT, 29% of the coronary arteries could not be evaluated because of artifacts. MDCT coronary angiography image quality and diagnostic performance have greatly improved after recent technical developments. Impact of Artifacts on MDCT Coronary Angiography Examples of artifacts will be shown that may help the reader recognize these artifacts when reporting MDCT coronary angiography. The causes of artifacts will be discussed in detail, with special attention to the effect of coronary artery size and motion. In this article, the impact of artifacts on MDCT coronary angiography will be explained. Hence, it is important that observers reporting MDCT coronary artery angiography investigations are aware of the potential presence of image artifacts and that these artifacts are recognized on the images. ![]() Parts of the coronary arteries cannot be evaluated with MDCT because of image artifacts, and image artifacts are the major cause of false-positive and false-negative interpretations. However, 2D conventional invasive X-ray coronary angiography is still considered the standard of reference for evaluating the coronary arteries because of its superior spatial and temporal resolutions compared with MDCT. From the first 4-MDCT feasibility studies to the current clinically applied 64-MDCT investigations, MDCT coronary angiography has evolved into a reliable 3D imaging technique for detecting and excluding coronary artery stenoses with high accuracy it is now considered an appropriate imaging tool for detecting coronary artery disease in certain clinical contexts. ![]()
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