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MDCT Determination of Volume and Function of the Left Ventricle: Are Short-Axis Image Reformations Necessary?

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

View larger version (70K): [in a new window]   Fig. 1A —Diagrams show anatomic orientation in image reformations from MDCT coronary angiography. SVC = superior vena cava, RA = right atrium, RV = right ventricle, PA = pulmonary artery, LA = left atrium, LV = left ventricle, Aa = ascending aorta, AA = aortic arch. Diagrams show anatomic orientation in axial (A) and short-axis (B) image reformations used for determination of left ventricular volumetric and function parameters from MDCT coronary angiography.

View larger version (87K): [in a new window]   Fig. 1B —Diagrams show anatomic orientation in image reformations from MDCT coronary angiography. SVC = superior vena cava, RA = right atrium, RV = right ventricle, PA = pulmonary artery, LA = left atrium, LV = left ventricle, Aa = ascending aorta, AA = aortic arch. Diagrams show anatomic orientation in axial (A) and short-axis (B) image reformations used for determination of left ventricular volumetric and function parameters from MDCT coronary angiography.

View larger version (20K): [in a new window]   Fig. 2A —Bland-Altman plots show study findings. Bland-Altman plots of left ventricular end-diastolic volumes (LVEDV) (A), left ventricular end-systolic volumes (LVESV) (B), and left ventricular ejection fractions (LVEF) (C) obtained from thick axial images (AX) and short-axis reformations (SA) depict agreement between mean differences (AX - SA) and mean values [(AX + SA) / 2] of both approaches. Mean difference was 24.9 ± 23.9 mL for LVEDV, 19.5 ± 19.3 mL for LVESV, and -0.5% ± 6.7% for LVEF.

View larger version (21K): [in a new window]   Fig. 2B —Bland-Altman plots show study findings. Bland-Altman plots of left ventricular end-diastolic volumes (LVEDV) (A), left ventricular end-systolic volumes (LVESV) (B), and left ventricular ejection fractions (LVEF) (C) obtained from thick axial images (AX) and short-axis reformations (SA) depict agreement between mean differences (AX - SA) and mean values [(AX + SA) / 2] of both approaches. Mean difference was 24.9 ± 23.9 mL for LVEDV, 19.5 ± 19.3 mL for LVESV, and -0.5% ± 6.7% for LVEF.

View larger version (22K): [in a new window]   Fig. 2C —Bland-Altman plots show study findings. Bland-Altman plots of left ventricular end-diastolic volumes (LVEDV) (A), left ventricular end-systolic volumes (LVESV) (B), and left ventricular ejection fractions (LVEF) (C) obtained from thick axial images (AX) and short-axis reformations (SA) depict agreement between mean differences (AX - SA) and mean values [(AX + SA) / 2] of both approaches. Mean difference was 24.9 ± 23.9 mL for LVEDV, 19.5 ± 19.3 mL for LVESV, and -0.5% ± 6.7% for LVEF.

View larger version (108K): [in a new window]   Fig. 3A —53-year-old man with coronary artery disease. Thick-section axial images and short-axis reformations from 16-MDCT show clear delineation of left ventricle (LV) cavity and myocardium in axial (A and D) and short-axis (B, C, E, and F) end-diastolic (A-C) and end-systolic (D-F) image reconstructions. Endocardial contours are outlined (white tracing) using automatic contour detection software (CT MASS [version 6.1], Medis). LV shape is in good agreement with short-axis cine MR images in end-diastolic and end-systolic phases of cardiac cycle.

View larger version (76K): [in a new window]   Fig. 3B —53-year-old man with coronary artery disease. Thick-section axial images and short-axis reformations from 16-MDCT show clear delineation of left ventricle (LV) cavity and myocardium in axial (A and D) and short-axis (B, C, E, and F) end-diastolic (A-C) and end-systolic (D-F) image reconstructions. Endocardial contours are outlined (white tracing) using automatic contour detection software (CT MASS [version 6.1], Medis). LV shape is in good agreement with short-axis cine MR images in end-diastolic and end-systolic phases of cardiac cycle.

View larger version (117K): [in a new window]   Fig. 3C —53-year-old man with coronary artery disease. Thick-section axial images and short-axis reformations from 16-MDCT show clear delineation of left ventricle (LV) cavity and myocardium in axial (A and D) and short-axis (B, C, E, and F) end-diastolic (A-C) and end-systolic (D-F) image reconstructions. Endocardial contours are outlined (white tracing) using automatic contour detection software (CT MASS [version 6.1], Medis). LV shape is in good agreement with short-axis cine MR images in end-diastolic and end-systolic phases of cardiac cycle.

View larger version (102K): [in a new window]   Fig. 3D —53-year-old man with coronary artery disease. Thick-section axial images and short-axis reformations from 16-MDCT show clear delineation of left ventricle (LV) cavity and myocardium in axial (A and D) and short-axis (B, C, E, and F) end-diastolic (A-C) and end-systolic (D-F) image reconstructions. Endocardial contours are outlined (white tracing) using automatic contour detection software (CT MASS [version 6.1], Medis). LV shape is in good agreement with short-axis cine MR images in end-diastolic and end-systolic phases of cardiac cycle.

View larger version (86K): [in a new window]   Fig. 3E —53-year-old man with coronary artery disease. Thick-section axial images and short-axis reformations from 16-MDCT show clear delineation of left ventricle (LV) cavity and myocardium in axial (A and D) and short-axis (B, C, E, and F) end-diastolic (A-C) and end-systolic (D-F) image reconstructions. Endocardial contours are outlined (white tracing) using automatic contour detection software (CT MASS [version 6.1], Medis). LV shape is in good agreement with short-axis cine MR images in end-diastolic and end-systolic phases of cardiac cycle.

View larger version (116K): [in a new window]   Fig. 3F —53-year-old man with coronary artery disease. Thick-section axial images and short-axis reformations from 16-MDCT show clear delineation of left ventricle (LV) cavity and myocardium in axial (A and D) and short-axis (B, C, E, and F) end-diastolic (A-C) and end-systolic (D-F) image reconstructions. Endocardial contours are outlined (white tracing) using automatic contour detection software (CT MASS [version 6.1], Medis). LV shape is in good agreement with short-axis cine MR images in end-diastolic and end-systolic phases of cardiac cycle.

View larger version (85K): [in a new window]   Fig. 4A —72-year-old man with three-vessel coronary artery disease and inferior and inferolateral infarction after bypass surgery. Images obtained from 16-MDCT reformations show reduced wall thickness during diastole and absence of wall thickening during systole for lateral and inferior wall of myocardium of left ventricle (LV). Note thinned inferior papillary muscle on short-axis image from 16-MDCT reformations during diastole (A) and systole (B).

View larger version (88K): [in a new window]   Fig. 4B —72-year-old man with three-vessel coronary artery disease and inferior and inferolateral infarction after bypass surgery. Images obtained from 16-MDCT reformations show reduced wall thickness during diastole and absence of wall thickening during systole for lateral and inferior wall of myocardium of left ventricle (LV). Note thinned inferior papillary muscle on short-axis image from 16-MDCT reformations during diastole (A) and systole (B).

View larger version (129K): [in a new window]   Fig. 4C —72-year-old man with three-vessel coronary artery disease and inferior and inferolateral infarction after bypass surgery. Images obtained from 16-MDCT reformations show reduced wall thickness during diastole and absence of wall thickening during systole for lateral and inferior wall of myocardium of left ventricle (LV). Thinned lateral LV wall is well delineated on axial image from 16-MDCT reformations in basal and midventricular segments during diastole (C) and systole (D).

View larger version (122K): [in a new window]   Fig. 4D —72-year-old man with three-vessel coronary artery disease and inferior and inferolateral infarction after bypass surgery. Images obtained from 16-MDCT reformations show reduced wall thickness during diastole and absence of wall thickening during systole for lateral and inferior wall of myocardium of left ventricle (LV). Thinned lateral LV wall is well delineated on axial image from 16-MDCT reformations in basal and midventricular segments during diastole (C) and systole (D).

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