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Quantitative assessment of right ventricular function and pulmonary regurgitation in surgically repaired tetralogy of Fallot using 256-slice CT: comparison with 3-Tesla MRI

  • Cardiac
  • Published:
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Abstract

Objectives

To compare 256-slice cardiac computed tomography (CCT) with cardiac magnetic resonance (CMR) imaging to assess right ventricular (RV) function and pulmonary regurgitant fraction (PRF) in patients with repaired tetralogy of Fallot (TOF).

Methods

Thirty-three consecutive patients with repaired TOF underwent retrospective ECG-gated CCT and 3-Tesla CMR. RV and left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) were measured using CCT and CMR. PRF-CCT (%) was defined as (RVSV − LVSV)/RVSV. PRF-CMR (%) was measured by the phase-contrast method. Repeated measurements were performed to determine intra- and interobserver variability.

Results

CCT measurements, including PRF, correlated highly with the CMR reference (r = 0.71–0.96). CCT overestimated RVEDV (mean difference, 17.1 ± 2.9 ml), RVESV (12.9 ± 2.1 ml) and RVSV (4.2 ± 2.0 ml), and underestimated RVEF (−2.6 ± 1.0 %) and PRF (−9.1 ± 2.0 %) compared with CMR. The limits of agreement between CCT and CMR were in a good range for all measurements. The variability in CCT measurements was lower than those in CMR. The estimated effective radiation dose was 7.6 ± 2.6 mSv.

Conclusions

256-slice CCT can assess RV function and PRF with relatively low dose radiation exposure in patients with repaired TOF, but overestimates RV volume and underestimates PRF.

Key points

• 256-slice CT assessment of RV function is highly reproducible in repaired TOF.

• Pulmonary regurgitation can be evaluated by biventricular systolic volume difference.

• CT overestimates RV volume and underestimates pulmonary regurgitation, compared with MRI.

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Abbreviations

CCT:

Cardiac computed tomography

CMR:

Cardiac magnetic resonance

CHD:

Congenital heart disease

ECG:

Electrocardiogram

EDV:

End-diastolic volume

EF:

Ejection fraction

ESV:

End-systolic volume

HU:

Hounsfield units

LV:

Left ventricle/ventricular

PR/PRF:

Pulmonary regurgitation/pulmonary regurgitant fraction

ROI:

Region of interest

RV:

Right ventricle/ventricular

SV:

Stroke volume

TOF:

Tetralogy of Fallot

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Acknowledgements

The scientific guarantor of this publication is Hiroshi Honda. The authors of this manuscript declare relationships with the following companies: Nagao M. and Kawanami S: Bayer Healthcare Japan, Modest, Research Grant; Philips Electronics Japan, Modest, Research Grant

Higuchi K.: Philips Electronics Japan, Employee. This study has received funding by the Japan Society for the Promotion of Science (JSPS) KAKENHI (25461831). No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Yuzo Yamasaki, Masato Yonezawa, Yoshio Matsuo, Takeshi Kamitani, Ko Higuchi & Hiroshi Honda

  2. Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Michinobu Nagao & Satoshi Kawanami

  3. Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kenichiro Yamamura

  4. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Ichiro Sakamoto

  5. Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Yuichi Shiokawa

  6. Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Hidetake Yabuuchi

Authors
  1. Yuzo Yamasaki
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  2. Michinobu Nagao
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  3. Kenichiro Yamamura
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  4. Masato Yonezawa
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  5. Yoshio Matsuo
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  6. Satoshi Kawanami
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  7. Takeshi Kamitani
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  8. Ko Higuchi
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  9. Ichiro Sakamoto
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  10. Yuichi Shiokawa
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  11. Hidetake Yabuuchi
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  12. Hiroshi Honda
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Corresponding author

Correspondence to Michinobu Nagao.

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Cite this article

Yamasaki, Y., Nagao, M., Yamamura, K. et al. Quantitative assessment of right ventricular function and pulmonary regurgitation in surgically repaired tetralogy of Fallot using 256-slice CT: comparison with 3-Tesla MRI. Eur Radiol 24, 3289–3299 (2014). https://doi.org/10.1007/s00330-014-3344-1

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  • DOI: https://doi.org/10.1007/s00330-014-3344-1

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