Korean J Radiol.  2011 Apr;12(2):156-162. 10.3348/kjr.2011.12.2.156.

Assessment of Left Ventricular Function and Volume in Patients Undergoing 128-Slice Coronary CT Angiography with ECG-Based Maximum Tube Current Modulation: a Comparison with Echocardiography

• Lim SJ
• Choo KS
• Park YH
• Kim JS
• Kim JH
• Chun KJ
• Jeong DW

• KMID: 1088559
• DOI: http://doi.org/10.3348/kjr.2011.12.2.156

Abstract

OBJECTIVE
To compare multi-detector CT (MDCT) using 128-slice coronary CT angiography (Definition AS+, Siemens Medical Solution, Forchheim, Germany) with ECG-based maximum tube current modulation with echocardiography for the determination of left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), end-systolic volume (ESV), as well as assessing coronary artery image quality and patient radiation dose.
MATERIALS AND METHODS
Thirty consecutive patients (M:F = 20:10; mean age, 57.9 +/- 11.4 years) were referred for MDCT for evaluation of atypical chest pain. EF, EDV and ESV were determined for both MDCT and echocardiography, and the correlation coefficients were assessed. Coronary artery segment subjective image quality (1, excellent; 4, poor) and radiation dose were recorded.
RESULTS
Left ventricular EF, EDV, and ESV were calculated by MDCT and echocardiography and the comparison showed a significant correlation with those estimated by echocardiography (p < 0.05). Consistently, the LVEFs calculated by MDCT and echocardiography were not statistically different. However, LV, EDV and ESV from MDCT were statistically higher than those from echocardiography (p < 0.05). The average image quality score of the coronary artery segment was 1.10 and the mean patient radiation dose was 3.99 +/- 1.85 mSv.
CONCLUSION
Although LV volume was overestimated by MDCT, MDCT provides comparable results to echocardiography for LVEF and LVV, with a low radiation dose.

Keyword

MDCT; Coronary Artery Disease; Left ventricular function; Echocardiography; Radiation

MeSH Terms

Coronary Angiography/*methods
Coronary Disease/*radiography/ultrasonography
Diastole
Echocardiography
*Electrocardiography
Female
Humans
Linear Models
Male
Middle Aged
Radiation Dosage
Radiographic Image Interpretation, Computer-Assisted
Stroke Volume
Systole
*Tomography, X-Ray Computed
Ventricular Dysfunction, Left/*radiography/ultrasonography

Figure

• 

  Fig. 1 Comparison of multi-detector CT (MDCT) and two-dimensional echocardiography in assessment of left ventricular ejection fraction. A. Linear regression plot shows correlation between left ventricular ejection fraction (EF) calculated by 128-slice multidetector CT and two-dimensional echocardiography. B. Bland-Altman plot of left ventricular ejection fraction shows difference between each pair plotted against average value of same pair and mean value of differences ± 2 standard deviations (SDs).

• 

  Fig. 2 Comparison of multi-detector CT (MDCT) and two-dimensional echocardiography in assessment of left ventricular end-diastolic volume. A. Linear regression plot shows correlation between left ventricular end-diastolic volume (EDV) calculated by 128-slice multidetector CT and two-dimensional echocardiography. B. Bland-Altman plot of left ventricular end-diastolic volume shows difference between each pair plotted against average value of same pair and mean value of differences ± 2 standard deviations (SDs).

• 

  Fig. 3 Comparison of multi-detector CT (MDCT) and two-dimensional echocardiography in assessment of left ventricular end-systolic volume. A. Linear regression plot shows correlation between left ventricular end-systolic volume (ESV) calculated by 128-slice multidetector CT and two-dimensional echocardiography. B. Bland-Altman plot of left ventricular end-systolic volume shows difference between each pair plotted against average value of same pair and mean value of differences ± 2 standard deviations (SDs).

• 

  Fig. 4 Difference of image quality depending on exposed maxinum tube current. A. Coronary artery anatomy quality was good at 100% of maximum tube current during mid-diastole and poor outside this phase with 4% of maximum tube current. B. Differentiating endocardium from lumen is available during all cardiac phase including phase with 4% of maximum tube current

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