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Determination of left ventricular ejection fraction using ultrafast computed tomography
Insights
Ultrafast CT accurately measures left ventricular ejection fraction in adults with heart disease. This non-invasive method shows excellent correlation with traditional ventriculography, offering a simpler diagnostic approach.
Area of Science:
- Cardiovascular Imaging
- Diagnostic Technology
Background:
- Left ventricular ejection fraction (LVEF) is a critical measure of cardiac function.
- Accurate LVEF assessment is vital for managing patients with congenital or acquired heart disease.
Purpose of the Study:
- To evaluate the efficacy of ultrafast computed tomography (CT) for measuring LVEF.
- To compare LVEF measurements obtained by ultrafast CT with those from cardiac catheterization (ventriculography).
Main Methods:
- Sixteen adult patients with heart disease underwent ultrafast CT scanning of the left ventricle.
- Contrast enhancement (Renografin-76) was used, with scanning timed for maximal left ventricular opacification.
- LVEF was calculated by measuring the change in left ventricular area from diastole to systole in a single mid-ventricular slice.
Main Results:
- The mean LVEF measured by ultrafast CT was 58.1 +/- 15.1%.
- LVEF measured by ventriculography was 59.6 +/- 12.3%.
- A strong correlation (r = 0.91, p < 0.001) was observed between LVEF by CT and ventriculography.
Conclusions:
- Ultrafast CT provides an accurate method for assessing left ventricular ejection fraction.
- The simple methodology of ultrafast CT makes it a valuable tool for cardiac diagnostics.
Abstract:
We evaluated ultrafast CT as a method to measure left ventricular ejection fraction in 16 adults with congenital or acquired heart disease who underwent cardiac catheterization. CT scanning of the left ventricle was performed at 4 to 12 adjacent 1 cm levels (depending on heart size) at 50 msec/scan for one cardiac cycle, with the table positioned with an axial tilt of 10 to 20 degrees and a lateral slew of 5 to 10 degrees to best approximate the long axis of the left ventricle. Image enhancement was achieved by an injection of 25 ml of Renografin-76 via a peripheral vein, with scanning timed to coincide with maximal enhancement of the left ventricular cavity. Ejection fraction was computed by measuring the percent change in area of the left ventricle from diastole (largest area) to systole (smallest area) in a single slice at the mid-left ventricular level. Mean ejection fraction for the group was 58.1 +/- 15.1% (range 24% to 84%). The ejection fraction from left ventriculography, computed from biplane images using the Dodge (area-length) formula, was 59.6 +/- 12.3% (range 28% to 77%). There was an excellent correlation between left ventricular ejection fraction by CT and ventriculography (r = 0.91, y = 1.1x - 8.5, p less than 0.001). This study demonstrates that ultrafast CT can provide an accurate measure of left ventricular ejection fraction by simple methodology.