[Left ventricular functional parameters using ECG-gated multidetector spiral CT in comparison with invasive ventriculography].
OBJECTIVE
To evaluate the accuracy of left ventricular function using a multidetector CT (MDCT) with retrospective ECG-gating and to compare the results with conventional ventriculography.


METHODS
In 26 patients, retrospectively ECG-gated MDCT of the heart (Volume Zoom, Siemens, Germany) as well as conventional coronary angiography including ventriculography was performed to exclude or follow coronary artery disease. CT examination (120 KV, 400 mAs) was carried out with 4 x 1 mm collimation (500 ms gantry rotation time). For CT angiography, 150 ml of contrast media was injected intravenously at a flow rate of 4 ml/s. All data sets of the functional cardiac parameters were reconstructed in end-systolic and end-diastolic phase. End-systolic volume (ESV), end-diastolic volume (EDV) and ejection fraction (EF) were determined from multiplanar reformations orthogonally through the cardiac short axis and analyzed using special evaluation software (ARGUS, Siemens). The results were compared with ESV, EDV and EF obtained from invasive ventriculography.


RESULTS
In all cases, a sufficient quality of the MDCT images was achieved. EDV (150.1 +/- 16.2 ml MDCT vs. 138.7 +/- 16.9 ml ventriculography; mean difference 11.4 +/- 12.7 ml; r = 0.51) had an acceptable correlation to conventional ventriculography, and ESV (58.1 +/- 14.6 ml vs. 50.2 +/- 13.4 ml; mean difference 7.9 +/- 8.8 ml; r = 0.81) and EF (60.9 +/- 13.6 % vs. 64.9 +/- 12.7 %; mean difference 4.0 +/- 6.2 %; r = 0.79) showed a good correlation. In comparison with invasive ventriculography, MDCT tended to overestimate significantly EDV (p = 0.008) and ESV (p = 0.003) and to underestimate EF (p = 0.001).


CONCLUSIONS
MDCT of the heart with retrospective ECG-gating enables efficient estimation of left ventricular function, providing important additional information of non-invasive cardiac imaging using MDCT. However, EDV and EVS were significantly overestimated and EF was underestimated in MDCT compared to ventriculography.
Heuschmid
M
M
Abteilung für Radiologische Diagnostik, Universitätsklinik Tübingen. martin.heuschmid@med.uni-tuebingen.de
Küttner
A
A
Schröder
S
S
Trebar
B
B
Burgstahler
C
C
Mahnken
A
A
Niethammer
M
M
Trabold
T
T
Kopp
A F
AF
Claussen
C D
CD
D000368:Aged; D016477:Artifacts; D002306:Cardiac Volume / Q000502:physiology; D017023:Coronary Angiography / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012985:Software Design; D013318:Stroke Volume / Q000502:physiology; D036542:Tomography, Spiral Computed / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology