Simultaneous Assessment of Left Ventricular Function and Coronary Artery Anatomy by Third-generation Dual-source Computed Tomography Using a Low Radiation Dose

다국어 초록 (Multilingual Abstract)

BACKGROUND: To assess left ventricular function and coronary artery simultaneously by third-generation dual-source computed tomography (CT) using a low radiation dose. METHODS: A total of 48 patients (36 men, 12 women; mean age 57.0 ± 9.5 years) who underwent both electrocardiography-gated cardiac CT angiography (CCTA) using 70–90 kVp and echocardiography were included in this retrospective study. The correlation between left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF) measured using CCTA and echocardiography was determined. The quality of coronary artery images was analyzed using a 4-point scale (1, excellent; 4, poor). The effective radiation dose of CCTA was calculated. RESULTS: Mean heart rate during the CT examination was 59.9 ± 9.9 bpm (range 38–79) and the body mass index of 48 patients was 24.5 ± 2.6 kg/m2 (range 17.0–29.4). LVEDV, LVESV, and LVEF measured using CCTA and echocardiography demonstrated a fair to moderate correlation (Pearson correlation coefficient: r = 0.395, p = 0.005 for LVEDV; r = 0.509. p < 0.001 for LVESV; r = 0.551, p < 0.001 for LVEF). Average image quality score of coronary arteries was 1.0 ± 0.1 (range 1–2). A total of 99.0% (783 of 791) of segments had an excellent image quality score, and 1.0% (8 of 791) of segments had a good score. Mean effective radiation dose was 2.2 ± 0.7 mSv. CONCLUSIONS: Third-generation dual-source CT using a low tube voltage simultaneously provides information regarding LV function and coronary artery disease at a low radiation dose. It can serve as an alternative option for functional assessment, particularly when other imaging modalities are inadequate.

참고문헌 (Reference)

1 "The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103" 37 : 1-332, 2007

2 Sung Min Ko, "Role of Cardiac Computed Tomography in the Diagnosis of Left Ventricular Myocardial Diseases" 한국심초음파학회 27 (27): 73-92, 2019

3 Lang RM, "Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology" 18 : 1440-1463, 2005

4 Norris RM, "Prognosis after recovery from myocardial infarction : the relative importance of cardiac dilatation and coronary stenoses" 13 : 1611-1618, 1992

5 Dewey M, "Patient characteristics as predictors of image quality and diagnostic accuracy of MDCT compared with conventional coronary angiography for detecting coronary artery stenoses : CORE-64 Multicenter International Trial" 194 : 93-102, 2010

6 Jakobs TF, "Multislice helical CT of the heart with retrospective ECG gating : reduction of radiation exposure by ECG-controlled tube current modulation" 12 : 1081-1086, 2002

7 Juergens KU, "Multi-detector row CT of left ventricular function with dedicated analysis software versus MR imaging : initial experience" 230 : 403-410, 2004

8 Palazzuoli A, "Left ventricular remodelling and systolic function measurement with 64 multi-slice computed tomography versus second harmonic echocardiography in patients with coronary artery disease : a double blind study" 73 : 82-88, 2010

9 Wu YW, "Left ventricular functional analysis using 64-slice multidetector row computed tomography : comparison with left ventriculography and cardiovascular magnetic resonance" 109 : 135-142, 2008

10 Arsanjani R, "Left ventricular function and volume with coronary CT angiography improves risk stratification and identification of patients at risk for incident mortality : results from 7758 patients in the prospective multinational CONFIRM observational cohort study" 273 : 70-77, 2014

11 White HD, "Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction" 76 : 44-51, 1987

12 Hausleiter J, "Image quality and radiation exposure with prospectively ECG-triggered axial scanning for coronary CT angiography: the multicenter, multivendor, randomized PROTECTION-III study" 5 : 484-493, 2012

13 Greupner J, "Head-to-head comparison of left ventricular function assessment with 64-row computed tomography, biplane left cineventriculography, and both 2- and 3-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging as the reference standard" 59 : 1897-1907, 2012

14 Farshad-Amacker NA, "Effect of high-pitch dual-source CT to compensate motion artifacts : a phantom study" 20 : 1234-1239, 2013

15 Mao SS, "Dual-standard reference values of left ventricular volumetric parameters by multidetector CT angiography" 7 : 234-240, 2013

16 Marano R, "Cross-modality accuracy of dual-step, prospectively electrocardiography-triggered dual-source computed tomorgaphy compared with same-day echocardiography and cardiac magnetic resonance imaging in the follow-up of heart-transplant patients" 33 : 217-224, 2018

17 Chuang ML, "Correlation of trabeculae and papillary muscles with clinical and cardiac characteristics and impact on CMR measures of LV anatomy and function" 5 : 1115-1123, 2012

18 Achenbach S, "Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition" 31 : 340-346, 2010

19 Meyersohn NM, "Coronary CT angiography in the emergency department utilizing second and third generation dual source CT" 11 : 249-257, 2017

20 Dill T, "Contraindications to magnetic resonance imaging : non-invasive imaging" 94 : 943-948, 2008

21 Cury RC, "Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT" 248 : 466-475, 2008

22 Butler J, "Comparison of multidetector computed tomography and two-dimensional transthoracic echocardiography for left ventricular assessment in patients with heart failure" 99 : 247-249, 2007

23 Meyer M, "Closing in on the K edge: coronary CT angiography at 100, 80, and 70 kV-initial comparison of a second- versus a third-generation dual-source CT system" 273 : 373-382, 2014

24 Abbara S, "Assessment of left ventricular function with 16-and 64-slice multi-detector computed tomography" 67 : 481-486, 2008

25 Ko SM, "Assessment of left ventricular ejection fraction and regional wall motion with 64-slice multidetector CT : a comparison with two-dimensional transthoracic echocardiography" 83 : 28-34, 2010

26 Bak SH, "Assessment of global left ventricular function with dual-source computed tomography in patients with valvular heart disease" 53 : 270-277, 2012

27 de Graaf FR, "Assessment of global left ventricular function and volumes with 320-row multidetector computed tomography : A comparison with 2D-echocardiography" 17 : 225-231, 2010

28 Henneman MM, "Assessment of global and regional left ventricular function and volumes with 64-slice MSCT : a comparison with 2D echocardiography" 13 : 480-487, 2006

29 임수진, "Assessment of Left Ventricular Function and Volume in Patients Undergoing 128-Slice Coronary CT Angiography with ECG-Based Maximum Tube Current Modulation: a Comparison with Echocardiography" 대한영상의학회 12 (12): 156-162, 2011

30 Rizvi A, "Analysis of ventricular function by CT" 9 : 1-12, 2015

31 Malm S, "Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography : a comparison with magnetic resonance imaging" 44 : 1030-1035, 2004

32 Austen WG, "A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association" 51 : 5-40, 1975

33 Koo TK, "A guideline of selecting and reporting intraclass correlation coefficients for reliability research" 15 : 155-163, 2016