title: Evaluation of left ventricular dysfunction using multiphasic reconstructions of coronary multi-slice computed tomography data in patients with chronic ischemic heart disease: validation against cine magnetic resonance imaging.
abstract: OBJECTIVE
  Multi-slice computed tomography (MSCT) is an emerging technique for the angiographic assessment of coronary artery disease (CAD). The purpose of this work was to determine if multiphasic reconstructions of the same data used for the assessment of CAD could also be used for global functional evaluation of the left ventricle (LV).
  
  
  METHODS
  Fifteen patients with chronic ischemic heart disease (CIHD) were imaged for CAD using a contrast-enhanced retrospective electrocardiographic-gated spiral technique on a MSCT scanner. The same data were reconstructed at both end-diastole and end-systole in order to measure left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV), and ejection fraction (LVEF). The results were compared to values obtained using a cine true-fast imaging with steady-state precession technique on a magnetic resonance imaging (MRI) scanner. Interobserver variability in the measurement from MSCT images was also evaluated.
  
  
  RESULTS
  For LVEF, there was substantial agreement between MSCT and MRI (intraclass correlation coefficient of 0.825); the intermodality reproducibility for LVEF (5%) was within an acceptable clinical range. However, mean values of LVEDV and LVESV with MSCT compared to cine MRI (LVEDV: 262.0 +/- 85.6 ml and 297.2 +/- 98.8 ml, LVESV: 196.2 +/- 75.6 ml and 218.6 +/- 90.99 ml, respectively) were significantly less for both volumes (p < 0.015). Intermodality variabilities for these measurements were high (15 and 13% for LVEDV and LVESV, respectively). Readers' mean measurements of LVESV from MSCT images were significantly different (p = 0.003) resulting in differences in calculation of LVEF (p < 0.024). Still, interobserver variabilities for all values were acceptable (6, 8, and 5% for LVEDV, LVESV, and LVEF, respectively).
  
  
  CONCLUSIONS
  Although values for LVEDV and LVESV were less with MSCT than with MRI, LVEF values were in agreement. This suggests that combined imaging of CAD and the evaluation of global LV dysfunction due to CIHD is feasible with the same MSCT acquisition.
authors.affiliation: Section of Cardiovascular Imaging, Division of Radiology Cleveland Clinic Foundation, Cleveland, OH 44195, USA. hallibs@ccf.org
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Halliburton
authors.forename: Martin
authors.initials: M
authors.lastname: Petersilka
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Schvartzman
authors.forename: Nancy
authors.initials: N
authors.lastname: Obuchowski
authors.forename: Richard D
authors.initials: RD
authors.lastname: White
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003327:Coronary Disease / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis*; D015588:Observer Variation; D036542:Tomography, Spiral Computed / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology
chemical_list: D003287:Contrast Media