Quantitative assessment of left ventricular function with dual-source CT in comparison to cardiac magnetic resonance imaging: initial findings
Quantitative assessment of left ventricular function with dual-source CT in comparison to cardiac magnetic resonance imaging: initial findings
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DOI：
10.1007/s00330-007-0767-y
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发表时间：
2008-03-01
影响因子：
5.9
通讯作者：
Nikolaou, K.
中科院分区：
文献类型：
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作者：
Busch, S.;Johnson, T. R. C.;Nikolaou, K.
心脏磁共振成像和超声心动图目前被认为是量化左心室容量和射血分数的标准方法。随着最近双源计算机断层扫描(DSCT)的引入，83ms的时间分辨率的提高也应该改善CT对心功能的评估。本研究的目的是以心脏磁共振成像(MRI)为参考标准，评价DSCT评价左心功能参数的准确性。15名患者(2名女性，13名男性；平均年龄50.8±-19.2岁)分别在DSCT(Somtom Definition；西门子医疗解决方案，德国Forchheim)和3.0Tesla MR扫描仪(Magnetom Trio；西门子医疗解决方案)上进行了CT和MRI检查。多期轴位CT图像由两个独立的盲观者使用半自动区域生长算法(Syngo循环；西门子医疗解决方案)进行分析。在MRI中，使用半自动轮廓检测软件(Argus；Siemens Medical Solutions)由两个读取器独立地评估短轴切片的动态电影环。测定两种方法的收缩末期容量(ESV)、舒张期末期容量(EDV)、射血分数(EF)和每搏输出量(SV)，并评估相关系数、系统误差、一致性限度和观察者间的变异性。DSCT的EDV和ESV分别为135.8±41.9ml和54.9±29.6ml，而MRI的EDV和ESV分别为132.1±40.8ml和57.6±27.3ml。因此，EDV被高估了3.7毫升(符合限-46.1/+53.6)，而ESV被低估了2.6毫升(-36.6/+31.4)。DSCT和MRI的平均EF分别为61.6+/-12.4%和57.9+/-9.0%，高估EF的误差为3.8%，两者的符合度分别为-14.7%和+22.2%。等级相关Rho值：EDV0.81(P=0.0024)，ESV0.79(P=0.0031)，EF 0.64(P=0.0168)。观察者间变异的卡伯值分别为EDV、ESV和EF为0.85。DSCT提供了根据冠状动脉CT血管成像数据量化左心功能的可能性，具有足够的诊断准确性，增加了该方法在全面心脏评估中的价值。观察到测量值的差异可能是由于不同的后处理方法和对注射对比剂而不使用β-受体阻滞剂的生理反应。
Cardiac magnetic resonance imaging and echocardiography are currently regarded as standard modalities for the quantification of left ventricular volumes and ejection fraction. With the recent introduction of dual-source computedtomography (DSCT), the increased temporal resolution of 83 ms should also improve the assessment of cardiac function in CT. The aim of this study was to evaluate the accuracy of DSCT in the assessment of left ventricular functional parameters with cardiac magnetic resonance imaging (MRI) as standard of reference. Fifteen patients (two female, 13 male; mean age 50.8 +/- 19.2 years) underwent CT and MRI examinations on a DSCT (Somatom Definition; Siemens Medical Solutions, Forchheim, Germany) and a 3.0-Tesla MR scanner (Magnetom Trio; Siemens Medical Solutions), respectively. Multiphase axial CT images were analysed with a semiautomatic region growing algorithms (Syngo Circulation; Siemens Medical Solutions) by two independent blinded observers. In MRI, dynamic cine loops of short axis slices were evaluated with semiautomatic contour detection software (ARGUS; Siemens Medical Solutions) independently by two readers. End-systolic volume (ESV), end-diastolic volume (EDV), ejection fraction (EF) and stroke volume (SV) were determined for both modalities, and correlation coefficient, systematic error, limits of agreement and inter-observer variability were assessed. In DSCT, EDV and ESV were 135.8 +/- 41.9 ml and 54.9 +/- 29.6 ml, respectively, compared with 132.1 +/- 40.8 ml EDV and 57.6 +/- 27.3 ml ESV in MRI. Thus, EDV was overestimated by 3.7 ml (limits of agreement -46.1/+53.6), while ESV was underestimated by 2.6 ml (-36.6/+31.4). Mean EF was 61.6 +/- 12.4% in DSCT and 57.9 +/- 9.0% in MRI, resulting in an overestimation of EF by 3.8% with limits of agreement at -14.7 and +22.2%. Rank correlation rho values were 0.81 for EDV (P=0.0024), 0.79 for ESV (P=0.0031) and 0.64 for EF (P=0.0168). The kappa value of inter-observer variability were amounted to 0.85 for EDV, ESV and EF. DSCT offers the possibility to quantify left ventricular function from coronary CT angiography datasets with sufficient diagnostic accuracy, adding to the value of the modality in a comprehensive cardiac assessment. The observed differences in the measured values may be due to different post-processing methods and physiological reactions to contrast material injection without beta-blocker medication.