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Evaluation of left ventricular dysfunction using multiphasic reconstructions of coronary multi-slice computed tomography data in patients with chronic ischemic heart disease: validation against cine magnetic resonance imaging

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Abstract

Purpose: Multi-slice computed tomography (MSCT) is an emerging technique for the angiographic assessment of coronary artery disease (CAD). The purpose of this work was to determine if multiphasic reconstructions of the same data used for the assessment of CAD could also be used for global functional evaluation of the left ventricle (LV). Materials and methods: Fifteen patients with chronic ischemic heart disease (CIHD) were imaged for CAD using a contrast-enhanced retrospective electrocardiographic-gated spiral technique on a MSCT scanner. The same data were reconstructed at both end-diastole and end-systole in order to measure left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV), and ejection fraction (LVEF). The results were compared to values obtained using a cine true-fast imaging with steady-state precession technique on a magnetic resonance imaging (MRI) scanner. Interobserver variability in the measurement from MSCT images was also evaluated. Results: For LVEF, there was substantial agreement between MSCT and MRI (intraclass correlation coefficient of 0.825); the intermodality reproducibility for LVEF (5%) was within an acceptable clinical range. However, mean values of LVEDV and LVESV with MSCT compared to cine MRI (LVEDV: 262.0 ± 85.6 ml and 297.2 ± 98.8 ml, LVESV: 196.2 ± 75.6 ml and 218.6 ± 90.99 ml, respectively) were significantly less for both volumes (p < 0.015). Intermodality variabilities for these measurements were high (15 and 13% for LVEDV and LVESV, respectively). Readers' mean measurements of LVESV from MSCT images were significantly different (p = 0.003) resulting in differences in calculation of LVEF (p < 0.024). Still, interobserver variabilities for all values were acceptable (6, 8, and 5% for LVEDV, LVESV, and LVEF, respectively). Conclusion: Although values for LVEDV and LVESV were less with MSCT than with MRI, LVEF values were in agreement. This suggests that combined imaging of CAD and the evaluation of global LV dysfunction due to CIHD is feasible with the same MSCT acquisition.

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References

  1. Klingenbeck-Regn K, Schaller S, Flohr T, et al. Subsecond multi-slice computed tomography: basics and applications. Eur J Radiol 1999; 31(2): 110–124.

    Google Scholar 

  2. Becker CR, Ohnesorge BM, Schoepf UJ, Reiser MF. Current development of cardiac imaging with multidetectorrow CT. Eur J Radiol 2000; 36(2): 97–103.

    Google Scholar 

  3. Achenbach S, Ulzheimer S, Baum U, et al. Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT. Circulation 2000; 102: 2823–2828.

    Google Scholar 

  4. Becker CR, Knez A, Ohnesorge B, Schoepf UJ, Reiser MF. Imaging of noncalcified coronary plaques using helical CT with retrospective ECG gating. AJR 2000; 175: 423–424.

    Google Scholar 

  5. Knez A, Becker C, Ohnesorge B, Haberl R, Reiser M, Steinbeck G. Noninvasive detection of coronary artery stenosis by multislice helical computed tomography. Circulation 2000; 101: e221.

    Google Scholar 

  6. Nieman K, Oudkerk M, Rensing BJ, et al. Coronary angiography with multi-slice computed tomography. The Lancet 2001; 357: 599–603.

    Google Scholar 

  7. Achenbach S, Giesler T, Ropers D, et al. Detection of coronary artery stenosis by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Circulation 2001; 103: 2535–2538.

    Google Scholar 

  8. Schroeder S, Kopp AF, Baumbach A, et al. Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography. J Am Coll Cardiol 2001; 37: 1430–1435.

    Google Scholar 

  9. Kopp AF, Schroeder S, Baumbach A, et al. Non-invasive characterization of coronary lesion morphology and composition by multislice CT: first results in comparison with intracoronary ultrasound. Eur Radiol 2001; 11: 1607–1611.

    Google Scholar 

  10. Schroeder S, Kopp A, Baumbach A, et al. Noninvasive detection of coronary lesions by multislice computed tomography: results of the new age pilot trial. Cathet Cardiovasc Intervent 2001; 53: 352–358.

    Google Scholar 

  11. Schroeder S, Kopp A, Ohnesorge B, et al. Accuracy and reliability of quantitative measurements in coronary arteries by multi-slice computed tomography: experimental and initial clinical results. Clin Radiol 2001; 56: 466–474.

    Google Scholar 

  12. Schroeder S, Kopp AF, Kuettner A, et. al. Influence of heart rate on vessels visibility in noninvasive coronary angiography using new multislice computed tomography. Experience in 94 patients. J Clin Imaging 2002; 26: 106–111.

    Google Scholar 

  13. Vogl TJ, Abolmaali ND, Diebold T, et al. Techniques for the detection of coronary atherosclerosis: multi-detector row CT coronary angiography. Radiology 2002; 223: 212–220.

    Google Scholar 

  14. Greenberg SB, Sandhu SK. Ventricular function. Radiol Clin N Am 1999; 37: 341–359.

    Google Scholar 

  15. Rich S, Chomka EV, Stagl R, Shanes JG, Kondos GT, Brundage BH. Determination of left ventricular ejection fraction using ultrafast computed tomography. Am Heart J 1986; 112(2): 392–296.

    Google Scholar 

  16. MacMillan RM, Rees MR, Maranhao V, Clark DL. Comparison of left ventricular ejection fraction by cine computed tomography and single plane right anterior oblique ventriculography. Angiology 1986; 37(4): 299–305.

    Google Scholar 

  17. MacMillan RM, Rees MR. Measurement of right and left ventricular volumes in humans by cine computed tomography: comparison to biplane cineangiography. Am J Card Imaging 1988; 2: 214–219.

    Google Scholar 

  18. MacMillan RM, Rees MR, Weiner R, et al. Assessment of global and regional left ventricular function in ischemic heart disease using ultrafast computed tomography. Catheter Cardio Diag 1988; 14: 248–254.

    Google Scholar 

  19. Pietras RJ, Wolfkiel CJ, Veselik K, Roig E, Chomka EV, Brundage BH. Validation of ultrafast computed tomographic left ventricular volume measurement. Invest Radiol 1991; 26: 28–34.

    Google Scholar 

  20. Schmermund A, Rensing BJ, Sheedy PF, Rumberger JA. Reproducibility of right and left ventricular volume measurements by electron-beam CT in patients with congestive heart failure. Int J Card Imaging 1998; 14: 201–209.

    Google Scholar 

  21. Markiewicz W, Sechtem U, Kirby R, Derugin N, Caputo GC, Higgins CB. Measurement of ventricular volumes in the dog by nuclear magnetic resonance imaging. J Am Coll Cardiol 1987; 10(1): 170–177.

    Google Scholar 

  22. Sechtem U, Pflugfelder PW, Gould RG, Cassidy MM, Higgins CB. Measurement of right and left ventricular volumes in healthy individuals with cine MR imaging. Radiology 1987; 163: 697–702.

    Google Scholar 

  23. Van Rossum AC, Visser FC, Sprenger M, Van Eenige MJ, Valk J, Roos JP. Evaluation of magnetic resonance imaging for determination of left ventricular ejection fraction and comparison with angiography. Am J Cardiol 1988; 62: 628–633.

    Google Scholar 

  24. Semelka RC, Tomei E, Wagner S, et al. Normal left ventricular dimensions and function: interstudy reproducibility of measurements with cine MR imaging. Radiology 1990; 174: 763–768.

    Google Scholar 

  25. Semelka RC, Tomei E, Wagner S, et al. Interstudy reproducibility of dimensional and functional measurements between cine magnetic resonance studies in the morphologically abnormal left ventricle. Am Heart J 1990; 1367–1373.

  26. Sakuma H, Fujita N, Foo TK, et al. Evaluation of left ventricular volume and mass with breath-hold cine MR imaging. Radiology 1993; 188: 377–380.

    Google Scholar 

  27. Pattynama PMT, Lamb HJ, van der Velde EA, van der Wall EE, de Roos A. Left ventricular measurements with cine and spin-echo MR imaging: a study of reproducibility with variance component analysis. Radiology 1993; 187: 261–268.

    Google Scholar 

  28. Ohnesorge B, Flohr T, Becker C, et al. Cardiac imaging by means of electrocardiographically gated multisection spiral CT: initial experience. Radiology 2000; 217: 564–571.

    Google Scholar 

  29. Bundy J, Simonetti O, Laub G, Finn JP. Segmented true-FISP cine imaging of the heart. International Society for Magnetic Resonance in Medicine, Seventh Scientific Meeting and Exhibition, May 1999, Philadelphia, Pennsylvania (Abstract).

  30. Lorenz CH, Walker ES, Morgan VL, Klein SS, Graham TP. Normal human right and left ventricular mass, systolic function, and gender differences by cine magnetic resonance imaging. J Cardiov Magn Reson 1999; 1(1): 7–21.

    Google Scholar 

  31. Lee KS, Marwick TH, Cook SA, et al. Prognosis of patients with left ventricular dysfunction, with and without viable myocardium after myocardial infarction. Relative efficacy of medical therapy and revascularization. Circulation 1994; 90: 2687–2694.

    Google Scholar 

  32. Bruder H, Schaller S, Ohnesorge B, Mertelmeier T. High temporal resolution volume heart imaging with multirow computed tomography. SPIE 1999; 3661: 420–432.

    Google Scholar 

  33. Kachelriess M, Ulzheimer S, Kalender WA. ECG-correlated image reconstruction from subsecond multi-slice spiral CT scans of the heart. Med Phys 2000; 27(8): 1881–1902.

    Google Scholar 

  34. Bahner M, Boese J, Lutz A, et al. Retrospectively ECGgated spiral CT of the heart and lung. Eur Radiol 1999; 9: 106–109.

    Google Scholar 

  35. Halliburton SS, Boese JM, Flohr TG, Lieber M, Kuzmiak SA, White RD. Improved volumetric analysis of the left ventricle using cardiac multi-slice computed tomography (MSCT) with high temporal resolution image reconstruction. Radiological Society of North America 88th Scientific Assembly and Annual Meeting. December 2002, Chicago, Illinois (Abstract).

  36. Fleischmann D, Hittmair K. Mathematical analysis of arterial enhancement and optimization of bolus geometry for CT angiography using the discrete Fourier transform. J Comput Assist Tomo 1999; 23(3): 474–484.

    Google Scholar 

  37. Bae KT, Tran HQ, Heiken JP. Multiphasic injection method for uniform prolonged vascular enhancement at CT angiography: pharmacokinetic analysis and experimental porcine model. Radiology 2000; 216: 872–880.

    Google Scholar 

  38. Barkhausen J, Ruehm SG, Goyen M, Buck T, Laub G, Debatin JF. MR evaluation of ventricular function: true fast imaging with steady-state precession versus fast low-angle shot cine MR imaging: feasibility study. Radiology 2001; 219: 264–269.

    Google Scholar 

  39. Plein S, Bloomer TN, Ridgway JP, Jones TR, Bainbridge GJ, Sivananthan MU. Steady-state free precession magnetic resonance imaging of the heart: comparison with segmented k-space gradient-echo imaging. JMRI 2001; 14: 230–236.

    Google Scholar 

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Authors and Affiliations

  1. Section of Cardiovascular Imaging, Division of Radiology, Cleveland Clinic Foundation, Cleveland, OH, USA

    Sandra S. Halliburton, Paulo R. Schvartzman & Richard D. White

  2. Siemens Medical Solutions, Forchheim, Germany

    Martin Petersilka

  3. Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, OH, USA

    Nancy Obuchowski

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  1. Sandra S. Halliburton
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  2. Martin Petersilka
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  4. Nancy Obuchowski
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  5. Richard D. White
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Halliburton, S.S., Petersilka, M., Schvartzman, P.R. et al. Evaluation of left ventricular dysfunction using multiphasic reconstructions of coronary multi-slice computed tomography data in patients with chronic ischemic heart disease: validation against cine magnetic resonance imaging. Int J Cardiovasc Imaging 19, 73–83 (2003). https://doi.org/10.1023/A:1021793420007

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