Artifacts — recognition & fixes

Five common cardiac CT artifacts: how to recognize each one and what to do about it (rescan, reconstruct, or live with it).

Five common artifacts — what each looks like and how to reduce it.

Most artifacts are fixable in post-processing. The few that aren’t (breathing) just mean the scan needs to be redone.

1
Breathing artifact

Recognition: noticeable step-off that involves the sternum/ribs alongside the heart.
Fix: cannot be fixed in post-processing — rescan the patient with better breath-hold instructions.

2
Columnation (stepoff) artifact

Recognition: step-off that does not involve the sternum — heart-only misalignment.
Fix: reconstruct the dataset at different cardiac phases.

3
Coronary motion artifact

Recognition: blurring or a crescent shape in a vessel (classically the RCA).
Fix: reconstruct at a different cardiac phase (mid-diastole or end-systole), or use a wider temporal window.

4
Streak & beam-hardening artifact

Recognition: dark hypoattenuated spots and bright radial streaks caused by high-density materials — pacemaker leads (especially the RA lead next to the RCA) absorbing low-energy photons.
Fix: high-energy X-rays or high-energy virtual monoenergetic images.

5
Blooming artifact

Recognition: extensive calcified plaques or stents visually “bloom” and obscure the lumen — leading to false-positive overestimation of stenosis.
Fix: reconstruct with thinner slices, sharper kernels, or iterative reconstruction (at the cost of higher noise).

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Reconstruction views (MPR, MIP, VR)