title: Accuracy of the long-axis area-length method for the measurement of left ventricular volumes and ejection fraction using multidetector computed tomography.
abstract: BACKGROUND
  Multidetector computed tomography (MDCT) is useful for assessing left ventricular (LV) volumes and function. Validation has mainly been carried out using Simpson's method of summing up consecutive short-axis areas. Because the latter method is time-consuming, many users prefer using a quicker method, based on a single view or a pair of views.
  
  
  OBJECTIVE
  To evaluate the accuracy of the long-axis area-length method (AL), which has not been validated for MDCT, using Simpson's method as the gold standard, as well as right anterior oblique LV angiography as a clinical standard.
  
  
  METHODS
  Twenty-three patients admitted with acute chest pain were clinically evaluated with electrocardiogram-gated MDCT and invasive LV angiography. MDCT-based end-diastolic, end-systolic and stroke volumes, and ejection fraction (EF) were calculated using Simpson's method, biplane AL and single-plane AL. For LV angiography, EF was calculated using single-plane AL.
  
  
  RESULTS
  A Bland-Altman analysis showed a close agreement between biplane AL and Simpson's method for EF, with 1% underestimation, 95% CI of +/-11% and a correlation of 0.89. For end-diastolic, end-systolic and stroke volumes, overestimations of 7 mL, 4 mL and 2 mL, and 95% CI of +/-27 mL, +/-15 mL and +/-26 mL, respectively were found. Correlation coefficients were 0.95, 0.97 and 0.82, respectively. Comparisons with LV angiography were considerably weaker. The vertical long-axis AL method by MDCT correlated better with both LV angiography and Simpson's method than the horizontal long-axis AL method.
  
  
  CONCLUSIONS
  The biplane AL method gives results for EF, which correspond closely with the more cumbersome Simpson's method, although volumes are slightly overestimated.
authors.affiliation: Department of Cardiology, Rambam Health Care Campus, Haifa, Israel. j_lessick@rambam.health.gov.il
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lessick
authors.forename: Eduard
authors.initials: E
authors.lastname: Ghersin
authors.forename: Sobhi
authors.initials: S
authors.lastname: Abadi
authors.forename: Sergey
authors.initials: S
authors.lastname: Yalonetsky
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D002983:Clinical Competence; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016277:Ventricular Function, Left
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