Multidetector computed tomography evaluation of left ventricular volumes: sources of error and guidelines for their minimization.
Multidetector computed tomography evaluation of left ventricular volumes: sources of error and guidelines for their minimization.
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DOI：
10.1016/j.jcct.2008.05.001
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发表时间：
2008-07-01
影响因子：
5.4
通讯作者：
Mor-Avi, Victor
中科院分区：
文献类型：
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作者：
Bardo, Dianna M E;Kachenoura, Nadjia;Mor-Avi, Victor
背景技术背景：尽管多排螺旋CT（MDCT）被认为高估了左心室（LV）收缩末期和舒张末期容积，（ESV、EDV）与磁共振成像参考相比，尚未彻底调查潜在的误差来源。我们试图定量评估重建相位数和用于体积计算的切片数对LV体积准确性的影响方法：在28例患者（Philips Brilliance 64）中获得的MDCT图像在每个心动周期的10、20、33和100个相位进行重建。对于每个相位数，在主动脉瓣关闭和二尖瓣打开之间测量ESV，并通过在100个相位/R-R下测量的参考ESV进行标准化。参考ESV和EDV均使用20个和单独10个固定厚度切片进行测量。使用重复measurement.RESULTS：在28例患者中的16例，收缩末期的时间随着重建相位的增加而变化，导致ESV从参考ESV的118 +/- 20%逐渐降低到100 +/-0%。切片数量的减少导致EDV和ESV显著增加（分别为4.2 +/- 3.2%和6.4 +/-5.5%），大约是相应的观察者内变异性（2.5 +/- 1.5%和3.8 +/- 2.4%）的两倍。结论：由于重建相位数量不足导致的收缩末期错误识别显著影响ESV测量。此外，用于体积计算的切片数量影响ESV和EDV，超出测量间变异性。为确保LV容积的准确定量，建议在小于RR间期5%的时间间期（>20个相位/心动周期）进行重建，并在>10个切片中追踪内膜边界。
BACKGROUND: Although multidetector computed tomography (MDCT) is known to overestimate left ventricular (LV) end-systolic and end-diastolic volumes (ESV, EDV) compared to magnetic resonance imaging reference, the potential sources of error have not been thoroughly investigated.OBJECTIVES: We sought to quantitatively assess the effects of the number of reconstructed phases and number of slices used for volume calculation on the accuracy of LV volume measurements.METHODS: MDCT images obtained in 28 patients (Philips Brilliance 64) were reconstructed at 10, 20, 33, and 100 phases per cardiac cycle. For each number of phases, ESV was measured between aortic valve closure and mitral valve opening and normalized by reference ESV measured at 100 phases/R-R. Both reference ESV and EDV were measured using 20 and separately 10 fixed-thickness slices. Reproducibility was assessed using repeated measurements.RESULTS: In 16 of 28 patients, the timing of end-systole varied with increasing number of reconstructed phases, resulting in a gradual decrease in ESV from 118 +/- 20% of reference ESV to 100 +/- 0%. Reduction in number of slices caused a significant increase in EDV and ESV (4.2 +/- 3.2% and 6.4 +/- 5.5%, respectively), roughly twice the corresponding intraobserver variability (2.5 +/- 1.5% and 3.8 +/- 2.4%).CONCLUSIONS: Misidentification of end-systole due to insufficient number of reconstructed phases significantly affects ESV measurements. Also, the number of slices used for volume calculation affects both ESV and EDV beyond intermeasurement variability. To ensure accurate quantification of LV volumes, reconstruction at time intervals smaller than 5% of the RR-interval (>20 phases/cardiac cycles) and tracing endocardial borders in >10 slices are recommended.