Brodoefel Harald, Kramer Ulrich, Reimann Anja, Burgstahler Christof, Schroeder Stephen, Kopp Andreas, Heuschmid Martin
Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.
AJR Am J Roentgenol. 2007 Nov;189(5):1064-70. doi: 10.2214/AJR.07.2228.
Functional analysis using MDCT has been limited by insufficient temporal resolution. The aim of this study was to assess the performance of a dual-source CT system with improved temporal resolution in the determination of both volume- or time-dependent functional parameters and regional wall motion in comparison with cine MRI.
Twenty patients (15 of whom had previous myocardial infarction) were prospectively examined using dual-source CT. MRI was used as the standard of reference. Using the Simpson's method, ventricular volumes were determined for the whole of the cardiac cycle and results compared using Parson's correlation and Bland-Altman analysis. Regional wall motion was assessed on cine images and compared using weighted kappa statistics.
Dual-source CT revealed a strong correlation with cine MRI regarding the quantification of end-diastolic volume (r = 0.98), end-systolic volume (r = 0.99), stroke volume (r = 0.96), and ejection fraction (r = 0.95). Good correlation was obtained for peak ejection rate (r = 0.79) and peak filling rate (r = 0.84), whereas agreement proved only moderate for time-to-peak ejection rate (r = 0.68) or time-to-peak filling rate from end-systole (r = 0.64). The mean difference for ejection fraction was negligible (bias, 0.72%). Good agreement between both techniques was likewise found for regional wall motion (kappa = 0.88).
With the improvement of temporal resolution between 42 and 83 milliseconds, dual-source CT not only enables accurate assessment of global functional parameters, but it also allows for quantification of time-dependent variables and reliable evaluation of regional wall motion.
使用多层螺旋CT(MDCT)进行功能分析一直受到时间分辨率不足的限制。本研究的目的是评估与电影磁共振成像(cine MRI)相比,具有更高时间分辨率的双源CT系统在确定体积或时间依赖性功能参数以及局部室壁运动方面的性能。
前瞻性地对20例患者(其中15例曾有心肌梗死病史)进行双源CT检查。以MRI作为参考标准。采用Simpson法测定整个心动周期的心室容积,并使用Parson相关分析和Bland-Altman分析比较结果。在电影图像上评估局部室壁运动,并使用加权kappa统计进行比较。
双源CT在舒张末期容积(r = 0.98)、收缩末期容积(r = 0.99)、每搏输出量(r = 0.96)和射血分数(r = 0.95)的量化方面与cine MRI显示出高度相关性。在射血峰值速率(r = 0.79)和充盈峰值速率(r = 0.84)方面获得了良好的相关性,而对于射血峰值时间(r = 0.68)或从收缩末期开始的充盈峰值时间(r = 0.64),一致性仅为中等。射血分数的平均差异可忽略不计(偏差为0.72%)。在局部室壁运动方面,两种技术之间也发现了良好的一致性(kappa = 0.88)。
随着时间分辨率提高到42至83毫秒,双源CT不仅能够准确评估整体功能参数,还能够对时间依赖性变量进行量化,并可靠地评估局部室壁运动。