Mahnken Andreas H, Katoh Marcus, Bruners Philipp, Spuentrup Elmar, Wildberger Joachim E, Günther Rolf W, Buecker Arno
Department of Diagnostic Radiology, Aachen University of Technology, Pauwelsstrasse 30, D-52074 Aachen, Germany.
Radiology. 2005 Jul;236(1):112-7. doi: 10.1148/radiol.2361040923. Epub 2005 Jun 13.
To assess global left ventricular (LV) function and regional wall motion with retrospective electrocardiographically gated 16-detector row computed tomography (CT) in comparison with magnetic resonance (MR) imaging.
In 15 pigs (mean weight, 53.9 kg +/- 9.5 [standard deviation]), acute myocardial infarction was induced with balloon occlusion of the left anterior descending coronary artery after approval was obtained from the committee on animal affairs. Thereafter, multi-detector row CT and MR imaging were performed with standardized examination protocols. From manually drawn endocardial and epicardial contours, LV volumes, including mean ejection fraction, peak filling rate (PFR), peak ejection rate (PER), time to PER, and time from end systole to PFR, were calculated. Regional wall motion was assessed from cine loops with a 16-segment model of the left ventricle. LV function was analyzed by using Bland-Altman plots, Student t test, and Pearson correlation coefficient. Regional wall motion scores were compared with weighted kappa statistic.
LV volumes determined with multi-detector row CT correlated well with MR imaging results, with an ejection fraction of 46.1% +/- 6.5 for multi-detector row CT and 46.8% +/- 5.9 for MR imaging (r = 0.97). PER, PFR, time to PER, and time from end systole to PFR showed a wide range of scattering and significant differences between multi-detector row CT and MR imaging for PER and time from end systole to PFR (P < .05). Regional wall motion scores showed a very high level of agreement with a kappa value of 0.88.
Although 16-detector row CT allows reliable assessment of LV volumes and regional wall motion at rest, it is not suited for assessment of all functional parameters.
采用回顾性心电图门控16排螺旋计算机断层扫描(CT)评估左心室(LV)整体功能和节段性室壁运动,并与磁共振(MR)成像进行比较。
在15头猪(平均体重53.9 kg±9.5[标准差])身上,经动物事务委员会批准后,通过球囊闭塞左前降支冠状动脉诱导急性心肌梗死。此后,按照标准化检查方案进行多排螺旋CT和MR成像检查。根据手动绘制的心内膜和心外膜轮廓,计算左心室容积,包括平均射血分数、峰值充盈率(PFR)、峰值射血率(PER)、达到PER的时间以及从收缩末期到PFR的时间。采用左心室16节段模型,通过电影环评估节段性室壁运动。使用Bland-Altman图、Student t检验和Pearson相关系数分析左心室功能。采用加权kappa统计量比较节段性室壁运动评分。
多排螺旋CT测定的左心室容积与MR成像结果相关性良好,多排螺旋CT的射血分数为46.1%±6.5,MR成像为46.8%±5.9(r = 0.97)。PER、PFR、达到PER的时间以及从收缩末期到PFR的时间显示出较大范围的离散,且多排螺旋CT与MR成像在PER和从收缩末期到PFR的时间方面存在显著差异(P < 0.05)。节段性室壁运动评分显示出非常高的一致性,kappa值为0.88。
尽管16排螺旋CT能够可靠地评估静息状态下的左心室容积和节段性室壁运动,但并不适合评估所有功能参数。