MDCT of right ventricular function: comparison of right ventricular ejection fraction estimation and equilibrium radionuclide ventriculography, part 1.
OBJECTIVE
The aim of this study was to calculate right ventricular ejection fraction by use of ECG-gated MDCT and to compare the results with those of equilibrium radionuclide ventriculography.


METHODS
Forty-nine consecutively examined patients (30 men, 19 women; mean age, 59 years) with known or suspected right ventricular dysfunction secondary to bronchopulmonary (n = 30) or pulmonary vascular (n = 19) disease underwent ECG-gated 16-MDCT angiography of the heart (rotation time, 0.42 second; 120 kV; 300 mAs; collimation, 12 x 0.75 mm; pitch, 0.2) after CT angiographic examination of the entire thorax according to a standard protocol. Biphasic administration of a 30% contrast agent was systematically performed (phase 1, 90 mL at 3 mL/s; phase 2, 30 mL at 1.5 mL/s); no patient received additional medication. Right ventricular ejection fraction was calculated after two reviewers in consensus determined the reconstruction windows and segmentation of the right ventricular cavity on a series of diastolic and systolic short-axis images. The results were compared with those of equilibrium radionuclide ventriculography.


RESULTS
At data acquisition, the mean (+/- SD) heart rate of the study group was 82 +/- 13.87 beats per minute (BPM) (range, 51-115 BPM). ECG showed a sinus rhythm in 30 (61%) of the patients and irregular cardiac rhythm in 19 (39%) of the patients. Agreement between the two techniques was estimated by intraclass correlation coefficient (0.77), the method of Bland and Altman (limits of concordance, -14.9 and 13.7), and percentage of variability between two measurements expressed by mean absolute percentage error (12.1%). The estimated effective dose for heart examination was 7.48 mSv with CT and 5 mSv with scintigraphy. The mean effective dose for the chest and heart CT examinations was 11.64 mSv.


CONCLUSIONS
Right ventricular ejection fraction can be reliably estimated with 16-MDCT in unselected patients.
Delhaye
Damien
D
Department of Thoracic Imaging, Hospital Calmette, University Center of Lille, Blvd. Jules Leclerc, 59037 Lille, France.
Remy-Jardin
Martine
M
Teisseire
Antoine
A
Hossein-Foucher
Claude
C
Leroy
Sylvie
S
Duhamel
Alain
A
Remy
Jacques
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015635:Radionuclide Ventriculography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*; D016278:Ventricular Function, Right