Cardiovascular Imaging - Original Article

Reduction of cardiac motion artifact in step-and-shoot coronary CT angiography with third-generation as compared with second-generation dual-source CT scanners


  • Liang Jin
  • Ji’an Zhou
  • Yiyi Gao
  • Wei Zhao
  • Ming Li
  • Zhizhong Wang

Received Date: 11.09.2019 Accepted Date: 17.07.2020 Diagn Interv Radiol 2021;27(4):482-487


We aimed to compare the effects of misregistration (stair-step artifact) occurrence during coronary computed tomography angiography (CCTA) using third- and second-generation dual-source computed tomography (DSCT) scanners.


CCTA was performed in consecutive patients with suspected coronary heart disease. Patients were randomly assigned to two groups and imaged using a third-generation (n=68; group A) or second-generation (n=63; group B) DSCT scanner. Heart rate (HR), heart rate variability (HRV), the number of acquisition steps required, and the anatomical cardiac length of each patient were recorded and compared between the two groups. Qualitative interpretation and analyses were scored with respect to subjective image quality and misregistration (stair-step artifact) by two interpreters. Cohen’s kappa was used to evaluate the consistency between the observers.


All CCTA images (100%) on both DSCT scanners yielded satisfactory image quality, with a subjective image quality score of 4.21±0.17. The consistency between the two observers with respect to misregistration and subjective scores were good (κ= 0.91 and 0.92, respectively). Both the number of acquisition steps required and the scan length of each patient in group A differed significantly (p < 0.001) from those in group B; there were significantly fewer artifacts in group A than in group B (p < 0.001). Misregistration artifacts did not correlate with the HRs or HRVs between two required acquisition steps (p > 0.20).


As compared with second-generation DSCT, the reduced number of acquisition steps required and the shorter scan length in third-generation DSCT reduced the occurrence of misregistration artifacts in CCTA images.