Coronary MS CTA quantifies LV function adequately

By Radiology Review

March 23, 2004 -- (Radiology Review) The value of different image reconstruction algorithms for assessment of left ventricular (LV) function using multislice CT (MSCT) recently was evaluated by radiologists at Aachen University of Technology in Germany.

Published in Acta Radiologica, the study was a comparison of MSCT using retrospective ECG gating and cine MRI. According to Dr. Andreas Mahnken and colleagues, "a precise quantitative and qualitative assessment of the LV function is important for diagnosis, prognosis and therapy in patients with various cardiac diseases." MRI has become the gold standard for LV function and ventricular wall motion assessment, although echocardiography remains the most commonly used diagnostic tool, they wrote.

MSCT has low temporal resolution compared with MRI. However, coronary MSCT angiography was adequate for quantification of LV function. Fifteen patients were scanned using standard and multisegmental image reconstruction, and short- and long-axis views were reconstructed. Volume calculation in end-systole and end-diastole was performed, as well as stroke volume, ejection fraction and myocardial mass. Observation of the LV wall motion provided qualitative assessment.

Results demonstrated the agreement between MSCT and MRI was acceptable for LV function quantification. "Applying the multisegmental image reconstruction algorithm, a significantly improved agreement with the MR data was found for end-diastolic volume, stroke volume and ejection fraction," they reported. Comparing MSCT with MRI for wall motion, standard image reconstruction showed agreement in 83.75% of segments, while multisegmental image reconstruction showed agreement in 92.5% of segments. 

According to the authors, LV function was best evaluated using multisegmental image reconstruction rather than standard image reconstruction.

"The use of a multisegmental image reconstruction algorithm with its improved temporal resolution yields a clinically relevant improvement in wall motion analysis and leads to a less distinct improvement of the quantitative analysis of the LV volumes and mass," they concluded.

Quantitative and qualitative assessment of left ventricular volume with ECG-gated multislice spiral CT: value of different image reconstruction algorithms in comparison to MRI
Mahnken, A. H., et. al.
Department of diagnostic radiology, Aachen University of Technology, Aachen, Germany
Acta Radiologica 2003 November; 44:604-611

By Radiology Review
March 23, 2004

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