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Measurement of myocardial extracellular volume using cardiac dual-energy computed tomography in patients with ischaemic cardiomyopathy: a comparison of different methods

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Abstract

To clarify the consistency and efficiency of four methods for myocardial extracellular volume (ECV) measurement (manual method using dual-energy iodine [manual ECViodine], manual method using subtraction [manual ECVsub], automatic ECViodine, automatic ECVsub) in patients with ischaemic cardiomyopathy. Fifty patients with ischaemic cardiomyopathy who underwent coronary computed tomography angiography (CCTA) following dual-energy computed tomography (CT) with late iodine enhancement (LIE-DECT) were included. LIE with ischaemic patterns representing scarring could be detected using iodine maps in all patients. The global and remote ECVs of non-scarred myocardium were measured using four methods (manual ECViodine, automatic ECViodine, manual ECVsub, and automatic ECVsub). The consistency and time cost of the four methods were analysed. There were no significant differences in the mean global ECVs or remote ECVs among the four methods (p > 0.05). ECViodine resulted in a lower Bland–Altman limit of agreement than that of ECVsub for both global and remote measurements. Intraclass correlation coefficients of the automatic and manual ECViodine measurements demonstrated better concordance (0.804 and 0.859, respectively) than those of automatic and manual ECVsub (0.607 and 0.669, respectively) for both global and remote measurements. The measurement time for automatic ECV was less than that for manual ECV for both global and remote ECV measurements (all p < 0.001). ECV measurement using dual-energy iodine yielded good concordance, and the automatic method has the advantages of being simple and convenient, which can become a useful tool for quantification of myocardial fibrosis.

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Abbreviations

CACS:

Coronary artery calcium scoring

CCT:

Cardiac computed tomography

CCTA:

Coronary computed tomography angiography

CI:

Confidence interval

CMR:

Cardiac magnetic resonance

DECT:

Dual-energy computed tomography

ECM:

Extracellular matrix

ECV:

Extracellular volume

ICC:

Interclass correlation coefficient

LB:

Linear blending

LGE:

Late gadolinium enhancement

LIE:

Late iodine enhancement

LOA:

Limits of agreement

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Acknowledgements

This study was supported by Jiangsu Provincial Medical Association Roentgen imaging research project (SYH-3201150-0010, 2021005), Nantong Basic Science Research Project (JC2021195). We would like to thank all the patients and volunteers who participated in this study.

Funding

Jiangsu Provincial Medical Association Roentgen imaging research project, SYH-3201150–0010, Rong-Xing Qi, 2021005, Rong-Xing Qi, Nantong Basic Science Research Project, JC2021195, Rong-Xing Qi

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Author notes

  1. Jun Shao and Jia-Shen Jiang have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The Affiliated Rudong Hospital of Nantong University, Jianghai (West) Road No. 2, Nantong, 226400, China

    Jun Shao & Su-Meng Wu

  2. Department of Radiology, The Second Affiliated Hospital of Nantong University, Haierxiang (North) Road No. 6, Nantong, 226001, China

    Jun Shao, Jia-Shen Jiang, Xiao-Yu Wang, Su-Meng Wu & Rong-Xing Qi

  3. Epidemiology and Medical Statistics, School of Public Health, Nantong University, Seyuan Road No. 9, Nantong, 226019, China

    Jing Xiao

  4. Cardiology, The Second Affiliated Hospital of Nantong University, Haierxiang (North) Road No. 6, Nantong, 226001, China

    Kou-Long Zheng

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  1. Jun Shao
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Correspondence to Kou-Long Zheng or Rong-Xing Qi.

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Shao, J., Jiang, JS., Wang, XY. et al. Measurement of myocardial extracellular volume using cardiac dual-energy computed tomography in patients with ischaemic cardiomyopathy: a comparison of different methods. Int J Cardiovasc Imaging 38, 1591–1600 (2022). https://doi.org/10.1007/s10554-022-02532-z

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  • DOI: https://doi.org/10.1007/s10554-022-02532-z

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