Nasir Khurram, Katz Ronit, Mao Songshou, Takasu Junichiro, Bomma Chandra, Lima Joao A C, Bluemke David A, Kronmal Richard, Carr J Jeffrey, Budoff Matthew J
Cardiac MRI PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
J Cardiovasc Comput Tomogr. 2008 May-Jun;2(3):141-8. doi: 10.1016/j.jcct.2008.01.003. Epub 2008 Jan 31.
A non-contrast-enhanced cardiac computed tomography (NCE-CCT) scan for assessing coronary artery calcification (CAC) is being increasingly used for assessing underlying burden of atherosclerosis. Although many studies document the potential value of measuring CAC, little is known about the other measures such as left ventricular (LV) geometry that can be obtained from the same scan data.
We sought to evaluate the accuracy of noncontrast CT-derived LV size (LVS; sum of LV volume and mass) compared with magnetic resonance imaging (MRI)-derived measures as the clinical reference standard.
Participants (n = 5004) in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent cardiac MRI studies from August 2000 to September 2002 were included. CT-derived LVS was defined as the sum of LV mass and LV intracavitary volume. The calculated LVS was taken from a measurement of a single slice from noncontrast images. Multivariate analysis adjusting for demographics was used to identify predictors of the relation between CT LVS and MRI LVS, and Bland-Altman analysis was performed comparing MRI-derived measures with CT-derived measure of LVS.
The mean CT LVS was 187.8 +/- 56.8 mL (range, 33.6-486.4 mL). The correlation was 0.73 (P = 0.01) for MRI-derived LV volume and 0.74 (P = 0.01) for MRI-derived LV mass. The correlation between CT LVS and MRI-derived LV end-diastolic total volume (mass + volume) was 0.79.
A single NCE-CT scan used to detect and quantify coronary calcification can also estimate LVS with reasonable accuracy compared with MRI. This provides a new method to study ventricular size in epidemiologic studies and potentially provide additional information for clinical screening of cardiac risk.
用于评估冠状动脉钙化（CAC）的非增强心脏计算机断层扫描（NCE-CCT）正越来越多地用于评估动脉粥样硬化的潜在负担。尽管许多研究记录了测量CAC的潜在价值，但对于可从相同扫描数据中获得的其他测量指标，如左心室（LV）几何结构，人们了解甚少。
我们试图评估与作为临床参考标准的磁共振成像（MRI）测量值相比，非增强CT衍生的左心室大小（LVS；左心室容积和质量之和）的准确性。
纳入2000年8月至2002年9月接受心脏MRI检查的动脉粥样硬化多民族研究（MESA）中的参与者（n = 5004）。CT衍生的LVS定义为左心室质量与左心室内腔容积之和。计算得出的LVS取自非增强图像单一层面的测量值。采用调整人口统计学因素的多变量分析来确定CT LVS与MRI LVS之间关系的预测因素，并进行Bland-Altman分析，比较MRI衍生测量值与CT衍生的LVS测量值。
CT LVS的平均值为187.8±56.8 mL（范围为33.6 - 486.4 mL）。MRI衍生的左心室容积的相关性为0.73（P = 0.01），MRI衍生的左心室质量的相关性为0.74（P = 0.01）。CT LVS与MRI衍生的左心室舒张末期总体积（质量 + 容积）之间的相关性为0.79。
用于检测和量化冠状动脉钙化的单次NCE-CT扫描与MRI相比，也能以合理的准确性估计LVS。这为流行病学研究中研究心室大小提供了一种新方法，并可能为心脏风险的临床筛查提供额外信息。
