[Evaluation of left ventricular wall characteristics in ischemic heart disease by cardiac CT examination].

Sixty-one cases with ischemic heart disease were examined with ECG-gated computed tomography (CT), and left ventricular (LV) wall properties were evaluated by the end-diastolic and end-systolic images of LV slices in terms of LV inner wall motion, LV wall thickness change in cardiac cycle and LV wall thinning. 1) Inner wall motion abnormalities of LV were detected by superimposing ED and ES images, and these coincided with angiocardiographic findings in 82% of LV segments, while assessment was difficult in the septal side because of its poor wall motion even in normal cases. In CT examination, both "hypokinesis" and "dyskinesis" in left ventriculography (LVG) were likely to be expressed as "akinesis" due to poor time resolution, causing difficulty in assessing the severity of abnormality. 2) In CT examination, changes in LV wall thickness during cardiac cycle were easily evaluated, especially in the septal segments. LV segments of a poor thickness change were well correlated with those of the abnormal wall motion assessed by LVG in 72% of LV segments. 3) In CT, LV wall contractility was finally evaluated by the combination of inner wall motion and wall thickness change, and the final assessments agreed with those observed in LVG in 84% of LV segments. 4) LV segments of abnormal motion evaluated by both inner wall motion and wall thickness change in CT image were well correlated with those observed by LVG (75%), and were thought to imply severe myocardial ischemia. 5) A great part of LV segments with wall thinning corresponded to the severely impaired wall motion observed in LVG (83%) and clinically identified myocardial infarction (87%). Wall thinning was well correlated with infarction.