Henneman Maureen M, Schuijf Joanne D, Jukema J Wouter, Holman Eduard R, Lamb Hildo J, de Roos Albert, van der Wall Ernst E, Bax Jeroen J
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
J Nucl Cardiol. 2006 Jul;13(4):480-7. doi: 10.1016/j.nuclcard.2006.03.005.
In patients with coronary artery disease (CAD), LV function and volumes are important parameters for long-term prognosis. Multislice computed tomography (MSCT) allows noninvasive assessment of the coronary arteries, but the accuracy of 64-slice MSCT for the assessment of left ventricular (LV) volumes and function is unknown.
A head-to-head comparison between 64-slice MSCT and 2-dimensional (2D) echocardiography was performed in 40 patients with known or suspected CAD. The LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were determined and the LV ejection fraction (LVEF) was derived. Regional wall motion was assessed visually using a 17-segment model. A 3-point scoring system was used to assign to each segment a wall motion score: 1 = normokinesia, 2 = hypokinesia, 3 = akinesia or dyskinesia. Two-dimensional echocardiography served as the gold standard. MSCT agreed well with 2D echocardiography for assessment of LVEDV (r = 0.97; p < .0001) and LVESV (r = 0.98; p < .0001). An excellent correlation between MSCT and 2D echocardiography was shown for the evaluation of LVEF (r = 0.91; p < .0001). Agreement for the assessment of regional wall motion was excellent (96%, kappa = 0.82).
An accurate assessment of global and regional LV function and volumes is feasible with 64-slice MSCT.
在冠心病(CAD)患者中,左心室(LV)功能和容积是长期预后的重要参数。多层螺旋CT(MSCT)可对冠状动脉进行无创评估,但64层MSCT评估左心室容积和功能的准确性尚不清楚。
对40例已知或疑似CAD患者进行了64层MSCT与二维(2D)超声心动图的直接比较。测定左心室舒张末期容积(LVEDV)和左心室收缩末期容积(LVESV),并计算左心室射血分数(LVEF)。使用17节段模型直观评估节段性室壁运动。采用3分评分系统为每个节段指定一个室壁运动评分:1=运动正常,2=运动减弱,3=运动消失或运动障碍。二维超声心动图作为金标准。MSCT在评估LVEDV(r = 0.97;p <.0001)和LVESV(r = 0.98;p <.0001)方面与二维超声心动图一致性良好。在评估LVEF方面,MSCT与二维超声心动图显示出极好的相关性(r = 0.91;p <.0001)。节段性室壁运动评估一致性极佳(96%,kappa = 0.82)。
64层MSCT能够准确评估左心室整体和节段性功能及容积。