Two-phase reconstruction for the assessment of left ventricular volume and function using retrospective ECG-gated MDCT: comparison with echocardiography.

OBJECTIVE The aims of our study were to investigate the clinical feasibility of a two-phase reconstruction method based on ECG to evaluate left ventricular (LV) volume and function using cardiac MDCT and to compare these results with those from echocardiography. SUBJECTS AND METHODS The LV end-diastolic and end-systolic volumes, stroke volume, and ejection fraction were measured using two different methods of cardiac MDCT in 19 patients who had undergone cardiac MDCT and echocardiography. The first was a two-phase reconstruction method based on retrospective ECG-triggering: The end-systolic phase was reconstructed when the reconstruction window was located halfway in the ascending T wave on ECG, and the end-diastolic phase was reconstructed when the reconstruction window was located at the starting point of the QRS complex on ECG. The second was a multiphase reconstruction method: 20 series of images were reconstructed at every 5% throughout the cardiac cycle. The LV volumes and function determined by the two reconstruction methods were compared. The results measured by cardiac MDCT were compared with those obtained by echocardiography. RESULTS The LV end-diastolic and end-systolic volumes, stroke volume, and ejection fraction measured by the two-phase reconstruction method correlated well with those measured by the multiphase reconstruction method (r = 0.984, 0.978, 0.969, 0.969, respectively). There were no significant differences between the results of the two different reconstruction methods (p > 0.05). The LV volumes showed moderate to good correlation between cardiac MDCT and echocardiography (0.766 < r < 0.940). Ejection fraction measured by cardiac MDCT yielded a significant overestimation of 2.9% +/- 8.7% (mean +/- SD) compared with that measured by echocardiography. CONCLUSION A two-phase reconstruction method on cardiac MDCT is relatively simple and can provide an objective standard for reconstructing the appropriate image sets for end-diastole and end-systole without the need to review serial preview images.

[1]  W. Heindel,et al.  Multi-detector row CT of left ventricular function with dedicated analysis software versus MR imaging: initial experience. , 2004, Radiology.

[2]  J Valk,et al.  Evaluation of magnetic resonance imaging for determination of left ventricular ejection fraction and comparison with angiography. , 1988, The American journal of cardiology.

[3]  C. Herzog,et al.  Heart-rate-adapted image reconstruction in multidetector-row cardiac CT: influence of physiological and technical prerequisite on image quality , 2002, European Radiology.

[4]  E. Wenkel,et al.  Noninvasive visualization of coronary arteries using contrast-enhanced multidetector CT: influence of heart rate on image quality and stenosis detection. , 2002, AJR. American journal of roentgenology.

[5]  Matthew J. Budoff,et al.  Assessment of Cardiac Function Using Multidetector Row Computed Tomography , 2006, Journal of computer assisted tomography.

[6]  O. Morel,et al.  Global left ventricular cardiac function: comparison between magnetic resonance imaging, radionuclide angiography, and contrast angiography. , 1999, Investigative radiology.

[7]  R M Whitlock,et al.  Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. , 1987, Circulation.

[8]  Walter Heindel,et al.  Using ECG-gated multidetector CT to evaluate global left ventricular myocardial function in patients with coronary artery disease. , 2002, AJR. American journal of roentgenology.

[9]  E Fleck,et al.  Comparison of magnetic resonance real-time imaging of left ventricular function with conventional magnetic resonance imaging and echocardiography. , 2001, The American journal of cardiology.

[10]  P. Mcmaster,et al.  Left ventricular dysfunction after acute myocardial infarction: results of a prospective multicenter study. , 1984, Journal of the American College of Cardiology.

[11]  Jeroen J. Bax,et al.  Usefulness of dynamic multislice computed tomography of left ventricular function in unstable angina pectoris and comparison with echocardiography. , 2002, The American journal of cardiology.

[12]  D. L. Johnston,et al.  Determination of ventricular ejection fraction: a comparison of available imaging methods. The Cardiovascular Imaging Working Group. , 1997, Mayo Clinic proceedings.

[13]  S. Colan,et al.  Evaluation of regional differences in right ventricular systolic function by acoustic quantification echocardiography and cine magnetic resonance imaging. , 1998, Circulation.

[14]  N. Reichek,et al.  Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. , 1989, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[15]  Matthijs Oudkerk,et al.  Coronary angiography with multi-slice computed tomography , 2001, The Lancet.

[16]  H Anno,et al.  Minimum scan speeds for suppression of motion artifacts in CT. , 1992, Radiology.

[17]  K. Hammermeister,et al.  Prognostic and predictive value of exertional hypotension in suspected coronary heart disease. , 1983, The American journal of cardiology.

[18]  C Georg,et al.  Coronary arteries: retrospectively ECG-gated multi-detector row CT angiography with selective optimization of the image reconstruction window. , 2001, Radiology.

[19]  W. Heindel,et al.  Evaluation of Global Left Ventricular Myocardial Function with Electrocardiogram-Gated Multidetector Computed Tomography: Comparison with Magnetic Resonance Imaging , 2003, Investigative radiology.

[20]  Werner Moshage,et al.  Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT. , 2000 .

[21]  G M Pohost,et al.  Left ventricular volume measurement using cardiac axis nuclear magnetic resonance imaging. Validation by calibrated ventricular angiography. , 1990, Circulation.