Multi-slice computer tomography of left ventricular function with automated analysis software in comparison with conventional ventriculography.
OBJECTIVE
To evaluate the accuracy of left ventricular volumetric and functional parameters from multi-slice computed tomography using automated analysis software, and to correlate results with those of invasive left ventriculography.


METHODS
In 145 consecutive patients (mean age, 61 years+/-12) known or suspected to have coronary artery disease, a 16-channel multi-slice computed tomography (Philips Mx8000 IDT 16) was performed using a standard technique. Using short-axis secondary multi-slice computed tomography reformations, we determined end-diastolic and end-systolic left ventricular volumes and ejection fraction with a commercially available analysis software capable of automated contour detection. Conventional left ventriculography was performed according to standard techniques within the following 24 h. Bland-Altman analysis was performed to calculate the limits of agreement and systematic errors between multi-slice computed tomography and conventional left ventriculography.


RESULTS
As determined by computer tomography, mean end-systolic (53+/-29 mL) left ventricular volumes had an acceptable correlation with conventional ventriculography (67+/-50 mL; r=0.74; p<0.001) and mean end-diastolic (119+/-33 mL) left ventricular volumes a poor correlation with conventional ventriculography measurements (154+/-69 mL; r=0.41). Left ventricular ejection fraction (57%+/-14 versus 55%+/-14 for conventional ventriculography; r=0.79) showed a very good correlation (p<0.001). Bland-Altman analysis showed acceptable limits of agreement (+/-9.2% for ejection fraction) without systematic errors.


CONCLUSIONS
The use of a multi-slice computed tomography with an automatic calculation software has a good correlation with conventional ventriculography findings and could accurately assess left ventricular function, but should not be used for ventricular volumes, because of biased estimations.
Department of Cardiology, EA 3878, Brest University Hospital, Brest, France. martine.gilard@chu-brest.fr
Martine
M
Gilard
Pierre-Yves
PY
Pennec
Jean-Christophe
JC
Cornily
Ulric
U
Vinsonneau
Gregoire
G
Le Gal
Michel
M
Nonent
Jacques
J
Mansourati
Jacques
J
Boschat
D002933:Cineradiography / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003936:Diagnosis, Computer-Assisted; D003935:Diagnostic Techniques, Cardiovascular / Q000295:instrumentation* / Q000592:standards; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D012984:Software; D015898:Tomography Scanners, X-Ray Computed / Q000145:classification / Q000592:standards*; D016277:Ventricular Function, Left
D003287:Contrast Media