Department of Radiology, Dongsan Hospital, Keimyung University College of Medicine, Daegu, Korea.
Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Korean J Radiol. 2020 Apr;21(4):450-461. doi: 10.3348/kjr.2019.0499.
We performed a meta-analysis to evaluate the agreement of cardiac computed tomography (CT) with cardiac magnetic resonance imaging (CMRI) in the assessment of right ventricle (RV) volume and functional parameters.
PubMed, EMBASE, and Cochrane library were systematically searched for studies that compared CT with CMRI as the reference standard for measurement of the following RV parameters: end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), or ejection fraction (EF). Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and correlation coefficient () between CT and CMRI. Heterogeneity was also assessed. Subgroup analyses were performed based on the probable factors affecting measurement of RV volume: CT contrast protocol, number of CT slices, CT reconstruction interval, CT volumetry, and segmentation methods.
A total of 766 patients from 20 studies were included. Pooled bias and LOA were 3.1 mL (-5.7 to 11.8 mL), 3.6 mL (-4.0 to 11.2 mL), -0.4 mL (5.7 to 5.0 mL), and -1.8% (-5.7 to 2.2%) for EDV, ESV, SV, and EF, respectively. Pooled correlation coefficients were very strong for the RV parameters ( = 0.87-0.93). Heterogeneity was observed in the studies (I² > 50%, < 0.1). In the subgroup analysis, an RV-dedicated contrast protocol, ≥ 64 CT slices, CT volumetry with the Simpson's method, and inclusion of the papillary muscle and trabeculation had a lower pooled bias and narrower LOA.
Cardiac CT accurately measures RV volume and function, with an acceptable range of bias and LOA and strong correlation with CMRI findings. The RV-dedicated CT contrast protocol, ≥ 64 CT slices, and use of the same CT volumetry method as CMRI can improve agreement with CMRI.
我们进行了一项荟萃分析，以评估心脏计算机断层扫描（CT）与心脏磁共振成像（CMRI）在评估右心室（RV）容积和功能参数方面的一致性。
系统检索了 PubMed、EMBASE 和 Cochrane 图书馆中比较 CT 与 CMRI 作为 RV 以下参数测量参考标准的研究：舒张末期容积（EDV）、收缩末期容积（ESV）、心搏量（SV）或射血分数（EF）。采用荟萃分析方法确定 CT 与 CMRI 之间的加权平均偏差、一致性界限（LOA）和相关系数（r）。还评估了异质性。根据可能影响 RV 容积测量的因素进行了亚组分析：CT 对比方案、CT 切片数、CT 重建间隔、CT 容积测量和分段方法。
共有来自 20 项研究的 766 名患者纳入研究。EDV、ESV、SV 和 EF 的平均偏差和 LOA 分别为 3.1 mL（-5.7 至 11.8 mL）、3.6 mL（-4.0 至 11.2 mL）、-0.4 mL（5.7 至 5.0 mL）和-1.8%（-5.7 至 2.2%）。RV 参数的平均相关系数很强（r = 0.87-0.93）。研究中存在异质性（I²＞50%，P＜0.1）。在亚组分析中，RV 专用对比方案、≥64 个 CT 切片、使用 Simpson 法进行 CT 容积测量以及包含乳头肌和小梁的方法，其平均偏差较低，LOA 较窄。
心脏 CT 能准确测量 RV 容积和功能，具有可接受的偏差和 LOA 范围，与 CMRI 结果具有很强的相关性。RV 专用 CT 对比方案、≥64 个 CT 切片以及与 CMRI 相同的 CT 容积测量方法的使用，可以提高与 CMRI 的一致性。
