Detection of left ventricular dysfunction on axial non-contrast chest CT
Masafumi Kaiume1, Ryo Kurokawa1, Eriko Maeda1
1Department of Radiology, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Insights
Axial non-contrast CT effectively detects left ventricular (LV) systolic and diastolic dysfunction. This imaging modality can reveal LV function even when performed for other clinical indications.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Left ventricular (LV) dysfunction, encompassing both systolic and diastolic impairments, is a critical indicator of cardiac health.
- Accurate and accessible methods for diagnosing LV dysfunction are essential for timely clinical management.
Purpose of the Study:
- To assess the diagnostic performance of axial non-contrast computed tomography (CT) in identifying left ventricular systolic and diastolic dysfunction.
- To determine specific CT imaging parameters that correlate with LV dysfunction.
Main Methods:
- A retrospective analysis of 178 participants who underwent both transthoracic ultrasonography and non-contrast chest CT.
- Patients were categorized into groups based on LV systolic dysfunction, LV diastolic dysfunction, and normal LV function, defined by established echocardiographic criteria.
- Various LV and cardiac dimensions measured on axial CT images were evaluated as predictive factors for LV dysfunction.
Main Results:
- A maximum transverse cardiac diameter (parameter IV) exceeding 131.2 mm indicated LV systolic dysfunction with 71.8% sensitivity and 77.0% specificity.
- A ratio of maximum left atrium anteroposterior diameter to anteroposterior thoracic diameter (parameter III/anteroposterior thoracic diameter) greater than 0.165 identified LV diastolic dysfunction with 77.8% sensitivity and 83.0% specificity.
Conclusions:
- Axial non-contrast CT imaging demonstrates utility in detecting left ventricular systolic and diastolic dysfunction.
- Incidental findings on CT scans performed for other reasons can provide valuable information regarding LV function, potentially prompting further investigation.
Purpose:
To evaluate the performance of axial non-contrast CT images in detecting systolic and diastolic left ventricular (LV) dysfunction.
Method:
This single-center retrospective study assessed 178 participants who underwent transthoracic ultrasonography and had non-contrast chest CT data within three months of ultrasonography. The patients were divided into LV systolic dysfunction (<52% ejection fraction in men and <54% in women), LV diastolic dysfunction (at least three of the following four criteria were met: average E/e' ratio >14; septal e' <7 cm/s or lateral e' <10 cm/s; peak tricuspid regurgitation velocity >2.8 m/s; or left atrial maximum volume index >34 ml/m2), and normal LV function groups. CT parameters were evaluated as predictive factors for LV dysfunction. These parameters were: I, maximum minor axis diameter of the LV lumen; II, I plus myocardial wall thickness; III, maximum left atrium anteroposterior diameter; IV, maximum transverse cardiac diameter; V, myocardial wall thickness; I-IV divided by maximum medial thoracic diameter; and I-IV divided by anteroposterior thoracic diameter. All parameters were measured on axial images: diameters were maximized.
Results:
LV systolic dysfunction was indicated when parameter IV exceeded 131.2 mm with sensitivity and specificity of 71.8% and 77.0%, respectively. Moreover, LV diastolic dysfunction was indicated when parameter III divided by anteroposterior thoracic diameter exceeded 0.165 with sensitivity and specificity of 77.8% and 83.0%, respectively.
Conclusions:
Axial non-contrast chest CT is useful for detecting LV dysfunction. Even CT scans for other purposes provide LV function information that may lead to appropriate examination.
More Related Videos
Related Concept Videos
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:28Imaging Studies for Cardiovascular System V: CT
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:24Cardiac Catheterization III: Left Heart Catheterization