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Updated: Jul 9, 2025
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Complimentary Cardiac Computed Tomography Ventricular Volumetry-Derived Metrics of Severity in Patients with Ebstein
Hyun Woo Goo1, Sang Hyub Park2
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. ghw68@hanmail.net.
Insights
Cardiac CT volumetry offers objective Ebstein anomaly severity assessment, complementing echocardiography. It shows significant differences between anomaly types and correlates well with echocardiographic indices, aiding in complex cases.
Area of Science:
- Cardiovascular Imaging
- Pediatric Cardiology
- Medical Imaging Analysis
Background:
- Detailed 3D cardiac segmentation using cardiac computed tomography (CT) is feasible for Ebstein anomaly.
- The complementary role of cardiac CT ventricular volumetry in assessing Ebstein anomaly severity remains unevaluated.
Purpose of the Study:
- To evaluate the complementary role of cardiac CT ventricular volumetry in assessing Ebstein anomaly severity.
- To compare CT-derived ventricular functional measures across different Carpentier types and surgical repair strategies.
Main Methods:
- Retrospective analysis of preoperative cardiac CT ventricular volumetry in 21 children with Ebstein anomaly.
- Comparison of CT-based ventricular functional measures (total RV, fRV volumes, fRV fraction, fRV/LV ratio, end-diastolic CT severity index) between Carpentier types and surgical repair types.
- Correlation of the Celermajer severity index (echocardiography) with CT-based functional parameters.
Main Results:
- Significant differences in total RV, fRV volumes, fRV fraction, fRV/LV ratio, and end-diastolic CT severity index were observed between Carpentier types A/B and C/D (p < 0.05).
- The Celermajer index showed a high positive correlation with the end-diastolic CT severity index (R = 0.720, p < 0.002).
- No significant differences in echocardiography- or CT-based functional measures were found between biventricular and one-and-a-half/univentricular repair groups (p > 0.05).
Conclusions:
- Cardiac CT ventricular volumetry objectively quantifies Ebstein anomaly severity.
- CT volumetry serves as a valuable adjunct to echocardiography, particularly when results are inconclusive or inconsistent.
- This technique aids in the comprehensive evaluation of Ebstein anomaly severity in pediatric patients.
Abstract:
Detailed three-dimensional cardiac segmentations using cardiac computed tomography (CT) data is technically feasible in patients with Ebstein anomaly, but its complementary role has not been evaluated. This single-center, retrospective study was aimed to evaluate the complementary role of cardiac CT ventricular volumetry in evaluating the severity of Ebstein anomaly. Preoperative cardiac CT ventricular volumetry was performed in 21 children with Ebstein anomaly. CT-based ventricular functional measures were compared between Carpentier types, and between definitive surgical repair types. The Celermajer severity index measured with echocardiography was correlated with CT-based functional parameters. Total right ventricle (RV) and functional RV (fRV) volumes, fRV fraction, fRV/left ventricle (LV) volume ratio, and end-diastolic CT severity index demonstrated statistically significant differences between Carpentier type A/B and Carpentier type C/D (p < 0.05). The Celermajer severity index measured with echocardiography showed a high positive correlation with the end-diastolic CT severity index (R = 0.720, p < 0.002). There were no statistically significant differences in both echocardiography- and CT-based functional measures between patients with biventricular repair and patients with one-and-a-half or univentricular repair (p > 0.05). Compared with echocardiography, cardiac CT ventricular volumetry can provide the severity of Ebstein anomaly objectively and may be used in select patients when echocardiographic results are inconclusive or inconsistent.
