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Using ECG-Gated Multidetector CT to Evaluate Global Left Ventricular Myocardial Function in Patients with Coronary Artery Disease

¹ Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Str. 33, D-48149 Muenster, Germany.
² Department of Cardiology and Angiology, University of Muenster, D-48149 Muenster, Germany.

View larger version (124K): [in a new window]   Fig. 1A. —65-year-old man with two-vessel coronary artery disease and chronic myocardial infarction. Multidetector CT (MDCT) image shows circumscribed aneurysmatic dilatation of left ventricular apex with thinning of myocardial wall (white arrows) in long-axis view. MV = mitral valve, LV = left ventricle, PPM = posterior papillary muscle.

View larger version (140K): [in a new window]   Fig. 1B. —65-year-old man with two-vessel coronary artery disease and chronic myocardial infarction. Image reformation in the four-chamber view from MDCT data sets shows that global left ventricular function was significantly reduced (left ventricular ejection fraction, 34%). Noncalcified plaque (asterisks) is present in lateral wall of descending aorta. White arrows point to thinning of myocardial wall. RV = right ventricle, LV = left ventricle, MV = mitral valve, DA = descending aorta.

View larger version (122K): [in a new window]   Fig. 2A. —62-year-old man with single-vessel coronary artery disease. Image shows multiplanar reformation generated from multidetector CT (MDCT) data sets from axial images using scanner's standard three-dimensional software. Sagittal plane (Sag, arrows) was tilted parallel to interventricular septum connecting left ventricular apex and middle level of mitral valve according to long-axis orientation of left ventricle. Then, plane for creating multiplanar reformations was tilted perpendicular to interventricular septum in axial images. SA = short-axis image orientation (arrows).

View larger version (108K): [in a new window]   Fig. 2B. —62-year-old man with single-vessel coronary artery disease. Image shows reformation from MDCT data sets with plane adjusted for image reformation parallel to plane of mitral valve in long-axis view to obtain images according to short-axis (SA, dashed arrows) orientation of left ventricle. AX = axial plane (arrows).

View larger version (112K): [in a new window]   Fig. 2C. —62-year-old man with single-vessel coronary artery disease. Image shows diastolic and systolic left ventricular volumes calculated using area—length method based on long-axis view. Endocardial contours were manually traced using standard planimetric software implemented in workstation. LA = left atrium, LV = left ventricle.

View larger version (98K): [in a new window]   Fig. 2D. —62-year-old man with single-vessel coronary artery disease. Images in end diastolic (D) and end systolic (E) phases of cardiac cycle show volumetric measurements of left ventricle (LV) calculated according to Simpson's method based on short-axis reformations. Endocardial contours of all short-axis reformations showing left ventricular cavity were manually traced using planimetric software; papillary muscles were included in left ventricular cavity. Left ventricular volumes were calculated by adding all measured cross-sectional areas multiplied by intersection thickness.

View larger version (95K): [in a new window]   Fig. 2E. —62-year-old man with single-vessel coronary artery disease. Images in end diastolic (D) and end systolic (E) phases of cardiac cycle show volumetric measurements of left ventricle (LV) calculated according to Simpson's method based on short-axis reformations. Endocardial contours of all short-axis reformations showing left ventricular cavity were manually traced using planimetric software; papillary muscles were included in left ventricular cavity. Left ventricular volumes were calculated by adding all measured cross-sectional areas multiplied by intersection thickness.

View larger version (18K): [in a new window]   Fig. 3A. —Plots show left ventricular ejection fraction determined from multidetector CT coronary angiographic data sets in patients with coronary artery disease. Graph shows correlation of results determined from short-axis reformations in comparison with data from biplane cineventriculography (r = 0.80, p < 0.05).

View larger version (18K): [in a new window]   Fig. 3B. —Plots show left ventricular ejection fraction determined from multidetector CT coronary angiographic data sets in patients with coronary artery disease. Graph shows correlation of results as assessed from reformations according to long-axis view in comparison with biplane cineventriculography (r = 0.76, p < 0.05).

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