title: Evaluation of biventricular ejection fraction with ECG-gated 16-slice CT: preliminary findings in acute pulmonary embolism in comparison with radionuclide ventriculography.
abstract: This study aimed to assess the feasibility of cardiac global function evaluation during a whole-chest multi-slice CT (MSCT) acquisition in patients referred for suspicion of pulmonary embolism (PE), and to compare the results with planar equilibrium radionuclide ventriculography (ERNA). Ten consecutive haemodynamically stable patients (six female, four male; mean age 69.7 years; heart rate 65-99 bpm) with suspicion of PE underwent an MSCT and ERNA within a 6 h period. CT acquisition was performed after contrast medium injection by using 16x1.5 mm collimation and retrospective ECG gating. Left ventricular (LVEF) and right ventricular (RVEF) ejection fractions were calculated using dedicated three-dimensional software. Relationships between measurements obtained with MSCT and ERNA were assessed using linear regression analysis and reliability of MSCT was assessed with intra-class correlation coefficient. Bland-Altman analysis was performed to calculate limits of agreement between MSCT and ERNA. MSCT was performed successfully in ten patients with a mean acquisition time of 16.5+/-2.8 s. Functional cardiac evaluation was possible on CT for all patients except for one due to poor opacification of right ventricle. Linear regression analysis showed a good correlation between MSCT and ERNA for the LVEF (R=0.91) and the RVEF (R=0.89) measurements. Intra-class correlation was superior for LVEF (0.92) than for the RVEF (0.68). Bland-Altman plots demonstrated that MSCT substantially overestimated the ERNA RVEF. Morphological CT data demonstrated PE in four of ten of patients and alternative diagnoses in five of ten patients. Our study reveals that MSCT with retrospective ECG gating may provide in one modality a morphological and a functional cardiopulmonary evaluation. Comparison with ERNA demonstrated a good correlation for both ventricular ejection fractions.
authors.affiliation: Department of Medical Imaging, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. coche@rdgn.ucl.ac.be
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Coche
authors.forename: Alain
authors.initials: A
authors.lastname: Vlassenbroek
authors.forename: Véronique
authors.initials: V
authors.lastname: Roelants
authors.forename: William
authors.initials: W
authors.lastname: D'Hoore
authors.forename: Franck
authors.initials: F
authors.lastname: Verschuren
authors.forename: Louis
authors.initials: L
authors.lastname: Goncette
authors.forename: Baudouin
authors.initials: B
authors.lastname: Maldague
mesh_terms: D000368:Aged; D003287:Contrast Media; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015635:Radionuclide Ventriculography; D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m; D013318:Stroke Volume / Q000502:physiology*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016277:Ventricular Function, Left / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m