Quantitative evaluation of regional left ventricular function by multidetector computed tomography.
OBJECTIVE
: Because most contemporary workstations offer quantitative analysis of regional function by multidetector computed tomography, we aimed to establish typical values for normal, hypokinetic, and akinetic regions, and to establish optimal thresholds to differentiate between normal and abnormal values.


METHODS
: For 33 patients, quantitative regional functional parameters were compared with visual analysis by both multidetector computed tomography and echocardiography. Normal values were established to normalize for segmental variability. Optimal thresholds were established to differentiate between normal and abnormal segments by receiver operating characteristic analysis.


RESULTS
: Akinetic, hypokinetic, and normokinetic segments demonstrated significant differences (P < 0.0001) for end-systolic thickness (mean [95% confidence interval], 9.4 [4.5-14.3], 11.7 [7.2-16.2], and 14.3 mm [8.2-20.3 mm]), respectively; thickening, 24% [-22% to 71%], 45% [-16% to 106%], and 82% [10%-154%]), respectively; and motion, 3.5 [-2.0 to 8.9], 6.1 [-0.2 to 12.4], and 8.5 mm [1.8-15.3 mm], respectively). Thickening performed best with area under the curve of 0.87 and sensitivity equal to specificity of 82%. Intraobserver variability was good, but interobserver variability was only moderate.


CONCLUSIONS
: Quantification of regional myocardial function can be performed to assist the physician in mapping left ventricular function.
Cardiology Department, Rambam Health Care Campus, Haifa, Israel. j_lessick@rambam.health.gov.il
Jonathan
J
Lessick
Tsur
T
Ben-Haim
Diab
D
Mutlak
Sobhi
S
Abadi
Yoram
Y
Agmon
Eduard
E
Ghersin
D000704:Analysis of Variance; D018780:Body Surface Potential Mapping / Q000379:methods; D004699:Endocardium / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010496:Pericardium / Q000000981:diagnostic imaging; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted; D012016:Reference Values; D012680:Sensitivity and Specificity; D012984:Software; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left