Quantitative assessment of left ventricular size and function: side-by-side comparison of real-time three-dimensional echocardiography and computed tomography with magnetic resonance reference.
BACKGROUND
Cardiac CT (CCT) and real-time 3D echocardiography (RT3DE) are being used increasingly in clinical cardiology. CCT offers superb spatial and contrast resolution, resulting in excellent endocardial definition. RT3DE has the advantages of low cost, portability, and live 3D imaging without offline reconstruction. We sought to compare both CCT and RT3DE measurements of left ventricular size and function with the standard reference technique, cardiac MR (CMR).


RESULTS
In 31 patients, RT3DE data sets (Philips 7500) and long-axis CMR (Siemens, 1.5 T) and CCT (Toshiba, 16-slice MDCT) images were obtained on the same day without beta-blockers. All images were analyzed to obtain end-systolic and end-diastolic volumes and ejection fractions using the same rotational analysis to eliminate possible analysis-related differences. Intertechnique agreement was tested through linear regression and Bland-Altman analyses. Repeated measurements were performed to determine intraobserver and interobserver variability. Both CCT and RT3DE measurements resulted in high correlation (r2 > 0.85) compared with CMR. However, CCT significantly overestimated end-diastolic and end-systolic volumes (26 and 19 mL; P < 0.05), resulting in a small but significant bias in ejection fraction (-2.8%). RT3DE underestimated end-diastolic and end-systolic volumes only slightly (5 and 6 mL), with no significant bias in EF (0.3%; P = 0.68). The limits of agreement with CMR were comparable for the 2 techniques. The variability in the CCT measurements was roughly half of that in either RT3DE or CMR values.


CONCLUSIONS
CCT provides highly reproducible measurements of left ventricular volumes, which are significantly larger than CMR values. RT3DE measurements compared more favorably with the CMR reference, albeit with higher variability.
Sugeng
Lissa
L
University of Chicago, MC5084, 5841 S Maryland Ave, Chicago, IL 60637, USA. lsugeng@medicine.bsd.uchicago.edu
Mor-Avi
Victor
V
Weinert
Lynn
L
Niel
Johannes
J
Ebner
Christian
C
Steringer-Mascherbauer
Regina
R
Schmidt
Frank
F
Galuschky
Christian
C
Schummers
Georg
G
Lang
Roberto M
RM
Nesser
Hans-Joachim
HJ
D000368:Aged; D019560:Echocardiography, Three-Dimensional / Q000191:economics / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000191:economics / Q000379:methods; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012984:Software; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000379:methods; D016277:Ventricular Function, Left