Kadoya Yoshito, Omaygenc Mehmet Onur, Chow Benjamin, Small Gary R
Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada.
Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada.
J Cardiovasc Comput Tomogr. 2025 Jan-Feb;19(1):74-80. doi: 10.1016/j.jcct.2024.09.011. Epub 2024 Oct 5.
Quantifying myocardial extracellular volume (ECV) using computed tomography (CT) has been shown to be useful in the evaluation of cardiac amyloidosis. However, the reproducibility of CT measurements for myocardial ECV, is not well-established in patients with proven cardiac amyloidosis.
This prospective single-center study enrolled cardiac amyloidosis patients to undergo dual-energy CT for myocardial fibrosis assessment. Delayed imaging at 7 and 8 min post-contrast and independent evaluations by two blinded cardiologists were performed for ECV quantification using 16-segment (ECV) and septal sampling (ECV). Inter- and intraobserver variability and test-retest reliability were measured using Spearman's rank correlation, Bland-Altman analysis, and intraclass correlation coefficients (ICC).
Among the 24 participants (median age = 78, 67 % male), CT ECV and ECV showed median values of 53.6 % and 49.1 % at 7 min, and 53.3 % and 50.1 % at 8 min, respectively. Inter- and intraobserver variability and test-retest reliability for CT ECV (ICC = 0.798, 0.912, and 0.894, respectively) and ECV (ICC = 0.791, 0.898, and 0.852, respectively) indicated good reproducibility, with no evidence of systemic bias between observers or scans.
Dual-energy CT-derived ECV measurements demonstrated good reproducibility in patients with proven cardiac amyloidosis, suggesting potential utility as a repeatable imaging biomarker for this disease.
利用计算机断层扫描（CT）定量心肌细胞外容积（ECV）已被证明在心脏淀粉样变性的评估中有用。然而，在已确诊的心脏淀粉样变性患者中，CT测量心肌ECV的可重复性尚未得到充分证实。
这项前瞻性单中心研究纳入了心脏淀粉样变性患者，对其进行双能量CT检查以评估心肌纤维化。在注射造影剂后7分钟和8分钟进行延迟成像，并由两名盲法心脏病专家进行独立评估，以使用16节段法（ECV）和间隔采样法（ECV）对ECV进行定量。使用Spearman等级相关性、Bland-Altman分析和组内相关系数（ICC）测量观察者间和观察者内的变异性以及重测可靠性。
在24名参与者（中位年龄=78岁，67%为男性）中，CT ECV和ECV在7分钟时的中位值分别为53.6%和49.1%，在8分钟时分别为53.3%和50.1%。CT ECV（ICC分别为0.798、0.912和0.894）和ECV（ICC分别为0.791、0.898和0.852）的观察者间和观察者内变异性以及重测可靠性表明具有良好的可重复性，没有证据表明观察者之间或扫描之间存在系统性偏差。
双能量CT衍生的ECV测量在已确诊的心脏淀粉样变性患者中显示出良好的可重复性，表明其作为这种疾病的可重复成像生物标志物具有潜在用途。
