title: Dual-standard reference values of left ventricular volumetric parameters by multidetector CT angiography.
abstract: BACKGROUND
  The papillary and trabecular muscles constitute a significant percentage of left ventricular mass and volume. The influence of the papillary and trabecular muscles on left ventricular parameters has not been described with multidetector CT angiography.
  
  
  OBJECTIVE
  The aims of this study are (1) to derive reference values for left ventricular volumetric parameters both including and excluding the papillary and trabecular muscles and (2) to establish the optimal segmentation method for measuring these values.
  
  
  METHODS
  A total of 179 subjects (mean age, 55.4 ± 9 years; 102 women) without heart disease and at low risk of cardiovascular disease who underwent CT angiography were selected. Left ventricular volumes, myocardial volume, and ejection fraction were measured with epicardial and 2 endocardial trace methods, including and excluding trace for the papillary and trabecular muscles. Values of all parameters obtained by both endocardial trace methods were compared.
  
  
  RESULTS
  Significant difference between both trace groups for all parameters on both sexes was found (P < .001). Significant differences in precision error of remeasurement were found in the including trace (3.6%) compared with the excluding trace (4.7%; P < .05) and in the epicardial trace (2.2%) compared with both endocardial traces (P < .001).
  
  
  CONCLUSIONS
  The left ventricular parameters measured by CT angiography were influenced significantly by the trace method by including or excluding the papillary and trabecular muscles. The dual-standard reference values of left ventricular parameters were established, and the optimal segmentation methods were definite in considering the heart size and image quality studied with retrospective and prospective CT angiography.
authors.affiliation: Los Angeles Biomedical Research Institute, Torrance, CA, USA.
authors.forename: Song Shou
authors.initials: SS
authors.lastname: Mao
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.forename: David G
authors.initials: DG
authors.lastname: Rosenthal
authors.forename: Michelle
authors.initials: M
authors.lastname: Cerilles
authors.forename: Irfan
authors.initials: I
authors.lastname: Zeb
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Flores
authors.forename: Yanlin
authors.initials: Y
authors.lastname: Gao
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods / Q000592:standards*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000592:standards*; D010210:Papillary Muscles / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012015:Reference Standards; D013318:Stroke Volume; D016277:Ventricular Function, Left
keywords: Computed tomography angiography; Left ventricular ejection fraction; Left ventricular mass; Left ventricular papillary and trabecular muscles; Left ventricular volume; Multi-detector row computed tomography