Evaluation of Global and Regional Left Ventricular Function With 16-Slice Computed Tomography, Biplane Cineventriculography, and Two-Dimensional Transthoracic Echocardiography
Comparison With Magnetic Resonance Imaging
Marc Dewey, MD*,*,
Mira Müller, MD*,
Stephan Eddicks, MD ,
Dirk Schnapauff, MD*,
Florian Teige, MD*,
Wolfgang Rutsch, MD,
Adrian C. Borges, MD and
Bernd Hamm, MD*
* Department of Radiology
Department of Cardiology, Charité, Medical School, Humboldt-University, Berlin, Germany
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Figure 1 Agreement for assessment of ejection fraction between magnetic resonance imaging (MRI) and multislice computed tomography (MSCT) (A) and MRI and biplane cineventriculography (CVG) (B) in 88 patients. The agreement is also compared with the reference standard (MRI) for MSCT and transthoracic echocardiography (Echo) (C and D) in the subset of 30 patients who underwent Echo. The mean of the 2 methods compared is always plotted against the difference of the 2. The solid line is the mean of the differences, whereas the dashed lines mark the limit of agreement (95% confidence intervals = 1.96 x SD) according to Bland and Altman (29). There were significantly larger limits of agreement for the comparison of CVG and Echo with MRI (B and D) than for the comparisons of MSCT with MRI (A and C).
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Figure 2 Agreement for assessment of end-diastolic volume between MRI and MSCT (A) and MRI and CVG (B) in 88 patients. The agreement is also compared with the reference standard (MRI) for MSCT and Echo (C and D) in the subset of 30 patients according to Bland and Altman as described in Figure 1. There were significantly larger limits of agreement for the comparison of CVG and Echo with MRI (B and D) than for the comparisons of MSCT with MRI (A and C), and there was also a significantly larger overestimation of the end-diastolic volume with CVG than with MSCT (A and B). Abbreviations as in Figure 1.
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Figure 3 Agreement for assessment of end-systolic volume between MRI and MSCT (A) and MRI and CVG (B) in 88 patients. The agreement is also compared with the reference standard (MRI) for MSCT and Echo (C and D) in the subset of 30 patients according to Bland and Altman as described in Figure 1. There were significantly larger limits of agreement for the comparison of CVG and Echo with MRI than for the comparisons of MSCT with MRI, and there was also a significantly larger overestimation of the end-systolic volume with CVG than with MSCT. Abbreviations as in Figure 1.
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Figure 5 Intraobserver agreement for assessment of ejection fraction (A), end-diastolic volume (B), and end-systolic volume (C) with MSCT in 29 patients randomly selected from the entire patient cohort. For all intraobserver analyses, the limits of agreement and the deviations from 0 were significantly smaller than for the comparison of MSCT with MRI (all p < 0.004) in the same 29 patients, demonstrating a low variability with MSCT. Abbreviations as in Figure 1.
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Figure 6 Example of a 48-year-old male patient with akinesia of the posterolateral wall on MRI (first column, short-axis view), MSCT (second column, short-axis view), CVG (third column, left anterior oblique view), and Echo (last column, short-axis view). Abbreviations as in Figure 1.
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