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Accuracy of Non-Electrocardiographically Gated Thoracic CT Angiography for Right Atrial and Right Ventricular

Zachary Nuffer1, Timothy M Baran1, Vijay Krishnamoorthy1

  • 1Department of Imaging Sciences (Z.N., T.M.B., K.K.J., A.C.) and Department of Medicine, Cardiology (V.K.), University of Rochester Medical Center, 601 Elmwood Ave, Box MED, Rochester, NY 14642.

Radiology. Cardiothoracic Imaging
|March 29, 2021
PubMed

Insights

Non-electrocardiographically (ECG) gated CT angiography can accurately diagnose right atrial (RA) and right ventricular (RV) enlargement using long-axis (LA) and short-axis (SA) measurements. This method provides reliable diagnostic values for identifying chamber enlargement without ECG gating.

Area of Science:

  • Radiology
  • Cardiovascular Imaging
  • Thoracic Imaging

Background:

  • Right atrial (RA) and right ventricular (RV) enlargement are significant indicators of cardiovascular disease.
  • Accurate assessment of RA and RV size is crucial for diagnosis and management.
  • Traditional methods often rely on electrocardiographically (ECG) gated CT angiography, which may not always be feasible.

Purpose of the Study:

  • To evaluate the utility of non-ECG-gated thoracic CT angiography for diagnosing RA and RV enlargement.
  • To determine the accuracy of long-axis (LA) and short-axis (SA) measurements in identifying RA and RV enlargement.
  • To establish cutoff values for these measurements in a non-ECG-gated setting.

Main Methods:

  • Retrospective review of 138 patients who underwent both non-ECG-gated and ECG-gated CT angiography.
  • Two blinded observers measured LA and SA dimensions of the RA and RV.
  • ECG-gated CT angiography-derived volumes served as the reference standard.

Main Results:

  • The product of atrial LA and SA measurements (threshold 3210 mm²) accurately predicted RA enlargement (94% sensitivity, 81.8% specificity).
  • LA diameter threshold of 55.5 mm showed 86% sensitivity and 78.4% specificity for RA enlargement.
  • RV enlargement was predicted by SA diameter > 48.5 mm (76.9% sensitivity) and BSA-indexed SA diameter of 27.0 mm/m² (92.3% sensitivity).

Conclusions:

  • Non-ECG-gated CT angiography is a viable tool for diagnosing RA and RV enlargement.
  • LA and SA measurements on non-ECG-gated CT scans provide accurate diagnostic information.
  • This approach simplifies the imaging protocol while maintaining diagnostic efficacy.
Abstract

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