与心脏磁共振成像相比，多排探测器心脏计算机断层扫描能准确量化右心室和左心室的大小及功能。

Multi-detector row cardiac computed tomography accurately quantifies right and left ventricular size and function compared with cardiac magnetic resonance.

作者信息

Raman Subha V, Shah Mona, McCarthy Beth, Garcia Anne, Ferketich Amy K

机构信息

Ohio State University Medical Center, Columbus, OH, USA.

出版信息

Am Heart J. 2006 Mar;151(3):736-44. doi: 10.1016/j.ahj.2005.04.029.

DOI:10.1016/j.ahj.2005.04.029

PMID:16504643

Abstract

BACKGROUND

Cardiac magnetic resonance (CMR) accurately quantifies right ventricular (RV) and left ventricular (LV) volumes and function. Limited availability of CMR and increasing use of MR-incompatible cardiovascular devices underscore the potential utility of cardiac computed tomography (CT) for ventricular quantification. This study quantified biventricular size and systolic function with multi-detector row CT compared with CMR imaging.

METHODS

Twenty-six subjects prospectively underwent CT and CMR examinations on a 16-detector CT and 1.5 T MR scanner, respectively; claustrophobia in one and nongated CT imaging in another precluded complete imaging in 2 subjects. Contiguous multiphase short-axis images were generated from axial CT data, and steady-state free precession cine MR produced contiguous short-axis cines. Semiautomated software generated ventricular borders to calculate volume, mass, and ejection fraction (EF) from both sets of images. Blinded observers completed quantification and wall motion analyses of 23 CMR and CT data sets independently.

RESULTS

All measures of LV size and function by cardiac CT correlated well with CMR over a wide range of LV function (LVEF 30%-72% by CMR), including end-diastolic volume (r = 0.97), end-systolic volume (r = 0.97), EF (r = 0.97), and mass (r = 0.95). Of 24 cases, 6 had inadequate contrast opacification of the RV precluding RV segmentation. In the remaining 18 CMR-CT data pairs, RVEF showed moderate agreement (r = 0.86), and RV volumes correlated well (r = 0.97 and 0.94 for RV end-diastolic volume and RV end-systolic volume, respectively). Ten percent of LV segments visualized by CT were inadequate for wall motion assessment due to motion artifact or inadequate contrast between myocardium and endocardium. For segments adequately visualized by both techniques, the mean kappa statistic was 0.88 (range 0.78-1.0), consistent with good agreement.

CONCLUSION

Cardiac CT accurately quantifies LV size and function; RV quantification with cardiac CT requires optimized contrast opacification of the RV.

摘要

背景

心脏磁共振成像（CMR）能够准确量化右心室（RV）和左心室（LV）的容积及功能。CMR设备的有限可用性以及与磁共振不兼容的心血管装置使用的增加，凸显了心脏计算机断层扫描（CT）在心室量化方面的潜在用途。本研究比较了多排探测器CT与CMR成像对双心室大小及收缩功能的量化情况。

方法

26名受试者分别在16排探测器CT和1.5T磁共振扫描仪上前瞻性地接受了CT和CMR检查；其中1名因幽闭恐惧症，另1名因非门控CT成像，导致2名受试者无法完成完整成像。从轴向CT数据生成连续的多期短轴图像，稳态自由进动电影磁共振成像生成连续的短轴电影图像。半自动软件生成心室边界，以从两组图像中计算容积、质量和射血分数（EF）。不知情的观察者独立完成了对23组CMR和CT数据集的量化及壁运动分析。

结果

在较宽的左心室功能范围内（CMR测量的左心室射血分数为30%-72%），心脏CT测量的所有左心室大小及功能指标与CMR均具有良好的相关性，包括舒张末期容积（r = 0.97）、收缩末期容积（r = 0.97）、EF（r = 0.97）和质量（r = 0.95）。在24例病例中，6例右心室对比剂充盈不佳，无法进行右心室分割。在其余18组CMR-CT数据对中，右心室射血分数显示出中度一致性（r = 0.86），右心室容积相关性良好（右心室舒张末期容积和右心室收缩末期容积的r分别为0.97和0.94）。CT显示的左心室节段中有10%因运动伪影或心肌与心内膜之间对比不足而无法进行壁运动评估。对于两种技术均能充分显示的节段，平均kappa统计量为0.88（范围0.78-1.0），表明一致性良好。