Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
Int J Cardiol. 2011 Nov 17;153(1):47-54. doi: 10.1016/j.ijcard.2010.08.036. Epub 2010 Sep 9.
To evaluate efficacy and reproducibility of 320-slice computed tomography (CT) for measuring left atrial (LA) maximum (LAVmax) and minimum volume (LAVmin) during the cardiac cycle, we compared CT with three- and two-dimensional (3D and 2D) transthoracic echocardiogram (TTE).
LAVmax and LAVmin (ml), and LA ejection fraction (LAEF) (%) were assessed in 22 consecutive subjects (15 males, 59.5 ± 15.1 years) using retrospective electrocardiogram gated 320-slice CT (Aquilion One, Toshiba Medical) and 3D-TTE (IE-33, Phillips). LAVmax and LAVmin were selected from the time volume curve. LAEF was calculated as (LAVmax-LAVmin)/LAVmax×100(%).
Mean ± standard deviation (SD) of LAVmax and LAV min were significantly larger by CT than 3D-TTE or 2D-TTE (both P<0.01). LAEF was 25.3 ± 13.1% by CT, 30.2 ± 6.8% by 3D-TTE (P=NS) and 33.9 ± 8.9% by 2D-TTE (P<0.05). The correlation coefficients (CCs) between CT and 3D-TTE in LAVmax, LAmin, and LAEF were 0.64, 0.68 and 0.57, respectively. Mean difference ± 1.96SD of LAVmax, LAVmin and LAEF by Bland and Altman analysis calculated from CT minus 3D-TTE were 48.8 ± 59.1 ml, 41.1 ± 63.2 ml, and -4.9 ± 21.1%, respectively. The CCs and mean difference ± 1.96SD between CT and 2D-TTE had similar tendencies. The CCs of interobserver variation were (for CT, 3D-TTE, 2D-TTE, respectively): 0.90, 0.95 and 0.94 (LAVmax), 0.97 and 0.97 and 0.93 (LAVmin), and 0.64, 0.77 and 0.34 (LAEF).
320-slice CT enables direct LAV measurements and has high reproducibility and positive correlation with 3D and 2D TTE. Absolute value of LAV by CT was larger than that by 3D and 2D TTE.
通过比较 320 层 CT 与三维（3D）和二维（2D）经胸超声心动图（TTE），评估 320 层 CT 测量心动周期中左心房（LA）最大容积（LAVmax）和最小容积（LAVmin）的效能和可重复性。
采用回顾性心电门控 320 层 CT（东芝医疗的 Aquilion One）和 3D-TTE（飞利浦的 IE-33）对 22 例连续患者（15 名男性，59.5±15.1 岁）进行 LAVmax 和 LAVmin（ml）和 LA 射血分数（LAEF）（%）评估。从时间容积曲线上选择 LAVmax 和 LAVmin。LAEF 计算为（LAVmax-LAVmin）/LAVmax×100（%）。
CT 测量的 LAVmax 和 LAVmin 的平均值±标准差（SD）明显大于 3D-TTE 或 2D-TTE（均 P<0.01）。CT 的 LAEF 为 25.3±13.1%，3D-TTE 为 30.2±6.8%（P=NS），2D-TTE 为 33.9±8.9%（P<0.05）。CT 与 3D-TTE 在 LAVmax、LAmin 和 LAEF 中的相关系数（CCs）分别为 0.64、0.68 和 0.57。Bland 和 Altman 分析计算的 CT 减去 3D-TTE 的 LAVmax、LAVmin 和 LAEF 的平均差值±1.96SD 分别为 48.8±59.1ml、41.1±63.2ml 和-4.9±21.1%。CT 与 2D-TTE 的 CCs 和平均差值±1.96SD 具有相似的趋势。观察者间变异的 CCs 分别为（对于 CT、3D-TTE、2D-TTE）：0.90、0.95 和 0.94（LAVmax）、0.97 和 0.97 和 0.93（LAVmin）和 0.64、0.77 和 0.34（LAEF）。
320 层 CT 可直接测量 LAV，具有较高的可重复性和与 3D 和 2D TTE 的正相关性。CT 测量的 LAV 值绝对值大于 3D 和 2D TTE。
