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Two-Phase Reconstruction for the Assessment of Left Ventricular Volume and Function Using Retrospective ECG-Gated MDCT: Comparison with Echocardiography

¹ Department of Radiology, Yonsei University College of Medicine, Yongdong Severance Hospital, 146-92 Dogok-Dong, Kangnam-Ku, Seoul, South Korea.
² Department of Cardiology, Yonsei University College of Medicine, Yongdong Severance Hospital, Seoul, South Korea.

View larger version (12K): [in a new window]   Fig. 1A —Two-phase reconstruction method based on ECG. Graphic shows that end-systolic (ES) phase was reconstructed on ECG when reconstruction window was located halfway in ascending T wave. End-diastolic (ED) phase was reconstructed when reconstruction window was located at starting point of QRS complex.

View larger version (108K): [in a new window]   Fig. 1B —Two-phase reconstruction method based on ECG. These short-axis multiplanar images in 48-year-old female undergoing screening for coronary artery disease are examples of images that were reformatted from end-systolic phase (B) and end-diastolic phase (C).

View larger version (113K): [in a new window]   Fig. 1C —Two-phase reconstruction method based on ECG. These short-axis multiplanar images in 48-year-old female undergoing screening for coronary artery disease are examples of images that were reformatted from end-systolic phase (B) and end-diastolic phase (C).

View larger version (12K): [in a new window]   Fig. 2A —Multiphase reconstruction method based on ECG. Graphic shows reconstruction windows are located throughout cardiac cycle at every 5% of cardiac cycle.

View larger version (128K): [in a new window]   Fig. 2B —Multiphase reconstruction method based on ECG. Image shows 20 sets of images that were reconstructed throughout cardiac cycle in 57-year-old male undergoing screening for coronary artery disease. These short-axis multiplanar reformatted images are arranged (left to right, top to bottom) from 5% to 100% of cardiac cycle.

View larger version (4K): [in a new window]   Fig. 3A —Graphs and summarized data for left ventricular (LV) volumes and ejection fraction by two reconstruction methods. Graph of LV volume curve (A) and table of summarized data (B) show 149.09 mL for end-diastolic volume and 68.11 mL for end-systolic volume by two-phase reconstruction method and results at only two points in A. Ejection fraction was calculated as 54.31%. Abbreviations shown in B are as follows: avg = average, EDV = end-diastolic volume, ES = end-systolic.

View larger version (39K): [in a new window]   Fig. 3B —Graphs and summarized data for left ventricular (LV) volumes and ejection fraction by two reconstruction methods. Graph of LV volume curve (A) and table of summarized data (B) show 149.09 mL for end-diastolic volume and 68.11 mL for end-systolic volume by two-phase reconstruction method and results at only two points in A. Ejection fraction was calculated as 54.31%. Abbreviations shown in B are as follows: avg = average, EDV = end-diastolic volume, ES = end-systolic.

View larger version (4K): [in a new window]   Fig. 3C —Graphs and summarized data for left ventricular (LV) volumes and ejection fraction by two reconstruction methods. Graph of LV volume curve (C) and table of summarized data (D) show 148.91 mL for end-diastolic volume and 69.23 mL for end-systolic volume by multiphase reconstruction method. Ejection fraction was calculated as 53.51%.

View larger version (39K): [in a new window]   Fig. 3D —Graphs and summarized data for left ventricular (LV) volumes and ejection fraction by two reconstruction methods. Graph of LV volume curve (C) and table of summarized data (D) show 148.91 mL for end-diastolic volume and 69.23 mL for end-systolic volume by multiphase reconstruction method. Ejection fraction was calculated as 53.51%.

View larger version (4K): [in a new window]   Fig. 4A —Bland-Altman plots show relationships between two reconstruction methods of cardiac MDCT. Plot shows relationships between two methods of cardiac MDCT for measurement of left ventricular end-diastolic volume (LVEDV) (A), left ventricular end-systolic volume (LVESV) (B), left ventricular stroke volume (LVSV) (C), and left ventricular ejection fraction (LVEF) (D). Mean differences (y-axes) between each pair of measurements were calculated using the following formula: [(mean TPRM) – (mean MPRM)]. Mean differences are plotted against average values (x-axes) of same pair. Average values were calculated using the following formula: [{(mean TPRM) + (mean MPRM)} / 2], where TPRM is two-phase reconstruction method and MPRM is multiphase reconstruction method. These results show good agreement, and significant differences were not found between the two reconstruction methods for end-diastolic volume, end-systolic volume, stroke volume, and ejection fraction.

View larger version (4K): [in a new window]   Fig. 4B —Bland-Altman plots show relationships between two reconstruction methods of cardiac MDCT. Plot shows relationships between two methods of cardiac MDCT for measurement of left ventricular end-diastolic volume (LVEDV) (A), left ventricular end-systolic volume (LVESV) (B), left ventricular stroke volume (LVSV) (C), and left ventricular ejection fraction (LVEF) (D). Mean differences (y-axes) between each pair of measurements were calculated using the following formula: [(mean TPRM) – (mean MPRM)]. Mean differences are plotted against average values (x-axes) of same pair. Average values were calculated using the following formula: [{(mean TPRM) + (mean MPRM)} / 2], where TPRM is two-phase reconstruction method and MPRM is multiphase reconstruction method. These results show good agreement, and significant differences were not found between the two reconstruction methods for end-diastolic volume, end-systolic volume, stroke volume, and ejection fraction.

View larger version (4K): [in a new window]   Fig. 4C —Bland-Altman plots show relationships between two reconstruction methods of cardiac MDCT. Plot shows relationships between two methods of cardiac MDCT for measurement of left ventricular end-diastolic volume (LVEDV) (A), left ventricular end-systolic volume (LVESV) (B), left ventricular stroke volume (LVSV) (C), and left ventricular ejection fraction (LVEF) (D). Mean differences (y-axes) between each pair of measurements were calculated using the following formula: [(mean TPRM) – (mean MPRM)]. Mean differences are plotted against average values (x-axes) of same pair. Average values were calculated using the following formula: [{(mean TPRM) + (mean MPRM)} / 2], where TPRM is two-phase reconstruction method and MPRM is multiphase reconstruction method. These results show good agreement, and significant differences were not found between the two reconstruction methods for end-diastolic volume, end-systolic volume, stroke volume, and ejection fraction.

View larger version (4K): [in a new window]   Fig. 4D —Bland-Altman plots show relationships between two reconstruction methods of cardiac MDCT. Plot shows relationships between two methods of cardiac MDCT for measurement of left ventricular end-diastolic volume (LVEDV) (A), left ventricular end-systolic volume (LVESV) (B), left ventricular stroke volume (LVSV) (C), and left ventricular ejection fraction (LVEF) (D). Mean differences (y-axes) between each pair of measurements were calculated using the following formula: [(mean TPRM) – (mean MPRM)]. Mean differences are plotted against average values (x-axes) of same pair. Average values were calculated using the following formula: [{(mean TPRM) + (mean MPRM)} / 2], where TPRM is two-phase reconstruction method and MPRM is multiphase reconstruction method. These results show good agreement, and significant differences were not found between the two reconstruction methods for end-diastolic volume, end-systolic volume, stroke volume, and ejection fraction.

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