[Multiserial ECG-gated computed tomographic method: Evaluation of left ventricular volumes, wall thickness and wall...

The purpose of this study was to investigate the potential usefulness of multiserial ECG-gated computed tomography (CT) (GE CT/T 8800) for a quantitative assessment of left ventricular volume, wall thickness and wall motion in 15 patients with coronary heart disease. In order to obtain ideal left ventricular short-axis images, the gantry was tilted to the cephalad 15 degree with patients on the right lateral position. Five ECG-gated scans (5.6 sec for one scan) were performed in each patient with intravenous injection of contrast material (Urografin 76). Left ventricular volumes were computed by a modified Simpson's rule and segmental wall motion was analyzed at three levels (base, papillary muscle and apex) by tracing the endocardial outline at end-diastole and end-systole. Left ventricular systolic and diastolic volumes ( LVSV , LVDV ) had a good correlation with those measured by left ventriculography (LVG) (r = 0.75 and 0.66). Wall thickness of the interventricular septum and left ventricular posterior wall obtained by CT was correlated with those by M-mode echocardiography (r = 0.82 and 0.71). Comparative analysis of segmental wall motion by CT, two-dimensional (2 D) echocardiography and left ventriculography was done. The 2 D echocardiographic segments with normal and abnormal wall motion were accurately identified by CT, best at the papillary muscle level (91%), and less at the base (71%) and the apex (73%). Similarly, 85% of left ventriculographic segments could be detected by CT. In conclusion, ECG-gated computed tomography proved to be a useful method for evaluating left ventricular function in coronary heart disease.