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FOCUS ISSUE: CARDIAC IMAGING: CLINICAL RESEARCH

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

Manuscript received January 25, 2006; revised manuscript received March 17, 2006, accepted April 17, 2006.

^_* Reprint requests and correspondence: Dr. Marc Dewey, Charité, Humboldt-Universität zu Berlin, Institut für Radiologie, Schumannstrasse 20/21, 10117 Berlin, Germany. (Email: marc.dewey{at}charite.de).

OBJECTIVES: We sought to compare left ventricular (LV) function assessed with multislice computed tomography (MSCT), biplane cineventriculography (CVG), and transthoracic echocardiography (Echo), with magnetic resonance imaging (MRI) as the reference standard.

BACKGROUND: With the same data as acquired for noninvasive coronary angiography, MSCT enables registration of myocardial function.

METHODS: A total of 88 patients (64 men and 24 women) underwent MSCT with 16 x 0.5 mm detector collimation, CVG, and MRI, whereas Echo was retrospectively analyzed in a subset of 30 patients.

RESULTS: Regarding the ejection fraction, the agreement was significantly superior for MSCT than for CVG (± 10.2% vs. ± 16.8%; p < 0.001) and Echo (± 11.0% vs. ± 21.2%; p < 0.001). For the end-diastolic and end-systolic volumes, the limits of agreement with CVG (p < 0.001) and Echo (p < 0.001 and p < 0.02, respectively) were also significantly larger than with MSCT. In comparison with MSCT, CVG significantly overestimated the end-diastolic and end-systolic volumes (p < 0.001). Intraobserver analysis of MSCT yielded limits of agreement for ejection fraction (± 4.8%), end-diastolic volume (± 15.6 ml) and end-systolic volume (± 8.0 ml), and myocardial mass (± 18.2 g). The accuracy in identifying patients and myocardial segments with abnormal regional function was significantly higher with MSCT (84% and 95%) than with CVG (63% and 90%; p < 0.002 and p < 0.001), whereas MSCT and Echo were not significantly different in identifying patients with abnormal regional function.

CONCLUSIONS: Our results indicate that the assessment of global and regional LV function with MSCT is more accurate than with CVG, whereas MSCT is superior to Echo for global function. This suggests that MSCT allows reliable evaluation of global and regional LV function.

Abbreviations and Acronyms   CVG = biplane cineventriculography   Echo = transthoracic echocardiography   LV = left ventricular/ventricle   MRI = magnetic resonance imaging   MSCT = multislice computed tomography

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