非心电图门控胸部CT血管造影对右心房和右心室扩大的诊断准确性
Accuracy of Non-Electrocardiographically Gated Thoracic CT Angiography for Right Atrial and Right Ventricular Enlargement.
作者信息
Nuffer Zachary, Baran Timothy M, Krishnamoorthy Vijay, Kaproth-Joslin Katherine, Chaturvedi Abhishek
机构信息
Department of Imaging Sciences (Z.N., T.M.B., K.K.J., A.C.) and Department of Medicine, Cardiology (V.K.), University of Rochester Medical Center, 601 Elmwood Ave, Box MED, Rochester, NY 14642.
出版信息
Radiol Cardiothorac Imaging. 2019 Oct 31;1(4):e190008. doi: 10.1148/ryct.2019190008. eCollection 2019 Oct.
PURPOSE
To assess the role of long-axis (LA) and short-axis (SA) measurements of the right atrium (RA) and right ventricle (RV) at non-electrocardiographically (ECG) gated thoracic CT angiography for identification of RA enlargement and RV enlargement.
MATERIALS AND METHODS
This study was a retrospective case review of 138 patients who underwent both non-ECG-gated CT angiography and ECG-gated CT angiography concurrently from November 2016 through November 2018. The SA and LA of the RA and RV were measured by two observers blinded to the ECG-gated CT angiography data. ECG-gated CT angiography-derived RA end-systolic and RV end-diastolic volumes were used as standard of reference to derive cutoff values for diagnosis of RA and RV enlargement.
RESULTS
In this study, 138 patients were evaluated (70 men, 68 women; mean age, 70.0 years ± 18.4 [standard deviation]; mean body mass index, 29.3 kg/m ± 8.1). Of these patients, ECG-gated CT angiography revealed 36.2% had RA enhancement and 19.0% had RV enhancement. The best predictor of RA enhancement was the product of atrial LA and SA measurements, for which a threshold value of 3210 mm yielded a 94% sensitivity and 81.8% specificity (area under the curve [AUC], 0.92). A threshold of 55.5 mm for LA diameter had 86% sensitivity and 78.4% specificity in identifying RA enlargement. RV enlargement could be predicted if the SA diameter was greater than 48.5 mm (76.9% sensitivity and 64.9% specificity) and with a body surface area indexed value of 27.0 mm/m (92.3% sensitivity and 74.8% specificity [AUC, 0.87]).
CONCLUSION
RA and RV enlargement can be accurately diagnosed by using non-ECG-gated CT angiography.© RSNA, 2019
目的
评估在非心电图门控胸部CT血管造影中，右心房（RA）和右心室（RV）的长轴（LA）和短轴（SA）测量对于识别RA扩大和RV扩大的作用。
材料与方法
本研究是一项回顾性病例分析，纳入了2016年11月至2018年11月期间同时接受非心电图门控CT血管造影和心电图门控CT血管造影的138例患者。由两名对心电图门控CT血管造影数据不知情的观察者测量RA和RV的SA和LA。以心电图门控CT血管造影得出的RA收缩末期容积和RV舒张末期容积作为参考标准，得出诊断RA和RV扩大的临界值。
结果
本研究共评估了138例患者（70例男性，68例女性；平均年龄70.0岁±18.4[标准差]；平均体重指数29.3kg/m²±8.1）。在这些患者中，心电图门控CT血管造影显示36.2%有RA增大，19.0%有RV增大。RA增大的最佳预测指标是心房LA和SA测量值的乘积，阈值为3210mm时，敏感性为94%，特异性为81.8%（曲线下面积[AUC]为0.92）。LA直径阈值为55.5mm时，识别RA增大的敏感性为86%，特异性为78.4%。如果SA直径大于48.5mm（敏感性76.9%，特异性64.9%）且体表面积指数值为27.0mm/m²（敏感性92.3%，特异性74.8%[AUC，0.87]），则可预测RV增大。
结论
使用非心电图门控CT血管造影可准确诊断RA和RV扩大。©RSNA，2019
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