title: Head-to-head comparison of left ventricular function assessment with 64-row computed tomography, biplane left cineventriculography, and both 2- and 3-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging as the reference standard.
abstract: OBJECTIVE
  This study was designed to compare the accuracy of 64-row contrast computed tomography (CT), invasive cineventriculography (CVG), 2-dimensional echocardiography (2D Echo), and 3-dimensional echocardiography (3D Echo) for left ventricular (LV) function assessment with magnetic resonance imaging (MRI).
  
  
  BACKGROUND
  Cardiac function is an important determinant of therapy and is a major predictor for long-term survival in patients with coronary artery disease. A number of methods are available for assessment of function, but there are limited data on the comparison between these multiple methods in the same patients.
  
  
  METHODS
  A total of 36 patients prospectively underwent 64-row CT, CVG, 2D Echo, 3D Echo, and MRI (as the reference standard). Global and regional LV wall motion and ejection fraction (EF) were measured. In addition, assessment of interobserver agreement was performed.
  
  
  RESULTS
  For the global EF, Bland-Altman analysis showed significantly higher agreement between CT and MRI (p < 0.005, 95% confidence interval: ±14.2%) than for CVG (±20.2%) and 3D Echo (±21.2%). Only CVG (59.5 ± 13.9%, p = 0.03) significantly overestimated EF in comparison with MRI (55.6 ± 16.0%). CT showed significantly better agreement for stroke volume than 2D Echo, 3D Echo, and CVG. In comparison with MRI, CVG-but not CT-significantly overestimated the end-diastolic volume (p < 0.001), whereas 2D Echo and 3D Echo significantly underestimated the EDV (p < 0.05). There was no significant difference in diagnostic accuracy (range: 76% to 88%) for regional LV function assessment between the 4 methods when compared with MRI. Interobserver agreement for EF showed high intraclass correlation for 64-row CT, MRI, 2D Echo, and 3D Echo (intraclass correlation coefficient >0.8), whereas agreement was lower for CVG (intraclass correlation coefficient = 0.58).
  
  
  CONCLUSIONS
  64-row CT may be more accurate than CVG, 2D Echo, and 3D Echo in comparison with MRI as the reference standard for assessment of global LV function.
authors.affiliation: Department of Radiology, Charité Medical School, Berlin, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Greupner
authors.forename: Elke
authors.initials: E
authors.lastname: Zimmermann
authors.forename: Andrea
authors.initials: A
authors.lastname: Grohmann
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Dübel
authors.forename: Till F
authors.initials: TF
authors.lastname: Althoff
authors.forename: Till
authors.initials: T
authors.lastname: Althoff
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Borges
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rutsch
authors.forename: Peter
authors.initials: P
authors.lastname: Schlattmann
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Marc
authors.initials: M
authors.lastname: Dewey
mesh_terms: D002933:Cineradiography; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016277:Ventricular Function, Left