Department of Radiology, Soon Chun Hyang University, Bucheon, Republic of Korea.
Acad Radiol. 2012 Apr;19(4):395-405. doi: 10.1016/j.acra.2011.11.012. Epub 2012 Jan 5.
The aim of this study was to investigate the impact of ventricular contrast medium attenuation on the accuracy of left ventricular (LV) and right ventricular (RV) function analysis on coronary computed tomographic angiographic (CCTA) imaging compared to cardiac magnetic resonance imaging (CMR).
Thirty patients (mean age, 61.9 ± 11.2 years; 14 men) underwent CCTA imaging and CMR. For both the right and left ventricles, end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV) were computed using multiphase image reconstruction of CCTA data. The accuracy of CCTA imaging was determined by subtracting CCTA measurements from CMR measurements. The accuracy of CCTA imaging was then correlated with the level of LV and RV contrast medium attenuation using regression analysis.
In the right ventricle, there was strong correlation between the accuracy of CCTA functional assessment of EDV (R(2) = 0.78, P < .001), ESV (R(2) = 0.36, P < .001), and SV (R(2) = 0.75, P < .001) and the level of RV contrast medium attenuation. In studies with lower RV enhancement (<176 Hounsfield units; n = 15), the mean CCTA deviations of EDV, ESV, and SV from CMR measurements were 43.6 ± 17.4, 11.2 ± 9.64, and 35.1 ± 11.5 mL, respectively. In studies with higher RV attenuation (>176 Hounsfield units; n = 15), these values were 13.6 ± 10, 8.0 ± 5.28, and 13 ± 4.96 mL, respectively. In the left ventricle, there was weak correlation between functional CCTA accuracy and LV attenuation (mean, 358.31 ± 68.71 Hounsfield units), and there was excellent correlation with CMR for LV EDV (R(2) = 0.86, P < .001), ESV (R(2) = 0.85, P < .001), and SV (R(2) = 0.51, P < .001).
If computed tomographic evaluation of RV function is desired, attention should be paid to the contrast injection protocol, because the accuracy of RV function analysis depends on the level of contrast medium attenuation. The high contrast medium attenuation that is typically achieved in the left ventricle routinely enables highly accurate measurements compared to CMR.
本研究旨在比较冠状动脉计算机断层血管造影（CCTA）成像与心脏磁共振成像（CMR），探讨心室造影剂衰减对左心室（LV）和右心室（RV）功能分析准确性的影响。
30 例患者（平均年龄 61.9 ± 11.2 岁；男性 14 例）接受了 CCTA 成像和 CMR 检查。使用多期图像重建技术从 CCTA 数据中计算右心室和左心室的舒张末期容积（EDV）、收缩末期容积（ESV）和每搏输出量（SV）。CCTA 成像的准确性通过从 CMR 测量值中减去 CCTA 测量值来确定。然后使用回归分析将 CCTA 成像的准确性与 LV 和 RV 造影剂衰减水平相关联。
在右心室中，EDV（R(2) = 0.78，P <.001）、ESV（R(2) = 0.36，P <.001）和 SV（R(2) = 0.75，P <.001）的 CCTA 功能评估准确性与 RV 造影剂衰减水平之间存在很强的相关性。在右心室增强程度较低（<176 亨氏单位；n = 15）的研究中，EDV、ESV 和 SV 的平均 CCTA 偏差分别为 43.6 ± 17.4、11.2 ± 9.64 和 35.1 ± 11.5 mL。在右心室增强程度较高（>176 亨氏单位；n = 15）的研究中，这些值分别为 13.6 ± 10、8.0 ± 5.28 和 13 ± 4.96 mL。在左心室中，CCTA 功能准确性与 LV 衰减之间存在弱相关性（平均 358.31 ± 68.71 亨氏单位），与 CMR 对 LV EDV（R(2) = 0.86，P <.001）、ESV（R(2) = 0.85，P <.001）和 SV（R(2) = 0.51，P <.001）的相关性良好。
如果需要进行 RV 功能的 CT 评估，应注意造影剂注射方案，因为 RV 功能分析的准确性取决于造影剂衰减水平。左心室通常会达到较高的造影剂衰减水平，这使得与 CMR 相比，左心室的测量结果高度准确。
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