Bansal Darpan, Singh Robin M, Sarkar Mrinalini, Sureddi Ravi, Mcbreen Kelly C, Griffis Timothy, Sinha Anjan, Mehta Jawahar L
Division of Cardiovascular Medicine, Arkansas Cardiology and the Central Arkansas Veterans Healthcare System, University of Arkansas for Medical Sciences, 4301 W. Markham St., Slot 532, Little Rock, AR 72205, USA.
Int J Cardiovasc Imaging. 2008 Mar;24(3):317-25. doi: 10.1007/s10554-007-9252-6. Epub 2007 Aug 16.
To compare global Left Ventricular (LV) systolic function assessment by 16-detector row Computed Tomography (MDCT) with Two-Dimensional Standard Echocardiography (2DSE) in a routine cardiology practice setting and to ascertain the degree of correlation between LV volumes and measurements obtained by 2DSE with those measured by MDCT.
In 52 patients with suspected coronary artery disease, a contrast enhanced MDCT study was performed using retrospective gating without dose modulation for better endocardial delineation. Eight phases of the cardiac cycle were analyzed to identify the end-diastolic and end-systolic phases. 2DSE was performed on the same day. Left ventricular systolic and diastolic volumes and ejection fraction were calculated in 4-chamber, 2-chamber and biplane (average of the two) views. Endocardial tracing was used to measure ventricular volumes by area length method for CT and Simpson's method for echocardiography.
On MDCT, mean LV ejection fraction (LVEF) in 4-chamber, 2-chamber and biplane views were 58.4 +/- 12, 59.3 +/- 12 and 59.7 +/- 12% respectively. On 2DSE, mean LVEF in 4-chamber, 2-chamber and biplane views were 58 +/- 14, 57 +/- 16 and 58 +/- 13% respectively. LVEF correlated best using the biplane views (r = 0.59 and P < 0.01) compared to 2-chamber (r = 0.57 and P < 0.01) and 4-chamber views (r = 0.32 and P = 0.02). Biplane measurement by these two techniques correlated well for LV volumes in both diastole (r = 0.69 and P < 0.01) and systole (r = 0.73 and P < 0.01), although MDCT consistently gave higher values.
MDCT can be a useful tool to measure LVEF while patients are undergoing CT coronary angiography.
在常规心脏病学实践环境中，比较16排螺旋计算机断层扫描（MDCT）与二维标准超声心动图（2DSE）对左心室（LV）整体收缩功能的评估，并确定2DSE与MDCT所测LV容积及测量值之间的相关程度。
对52例疑似冠心病患者进行对比增强MDCT研究，采用回顾性门控且无剂量调制以更好地勾勒心内膜。分析心动周期的8个阶段以确定舒张末期和收缩末期阶段。同日进行2DSE检查。在四腔心、两腔心和双平面（两者平均值）视图中计算左心室收缩和舒张容积以及射血分数。采用心内膜追踪，通过面积长度法测量CT心室容积，通过辛普森法测量超声心动图心室容积。
在MDCT上，四腔心、两腔心和双平面视图中的平均左心室射血分数（LVEF）分别为58.4±12%、59.3±12%和59.7±12%。在2DSE上，四腔心、两腔心和双平面视图中的平均LVEF分别为58±14%、57±16%和58±13%。与两腔心视图（r = 0.57，P < 0.01）和四腔心视图（r = 0.32，P = 0.02）相比，双平面视图中LVEF的相关性最佳（r = 0.59，P < 0.01）。这两种技术的双平面测量在舒张期（r = 0.69，P < 0.01）和收缩期（r = 0.73，P < 0.01）对LV容积的相关性均良好，尽管MDCT测量值始终较高。
在患者进行CT冠状动脉造影时，MDCT可作为测量LVEF的有用工具。
