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Four-dimensional computed tomography: a method of assessing right ventricular outflow tract and pulmonary artery deformations throughout the cardiac cycle

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Abstract

Objective

To characterise 3D deformations of the right ventricular outflow tract (RVOT)/ pulmonary arteries (PAs) during the cardiac cycle and estimate the errors of conventional 2D assessments.

Methods

Contrast-enhanced, ECG-gated cardiovascular computed tomography (CT) findings were retrospectively analysed from 12 patients. The acquisition of 3D images over 10 phases of the cardiac cycle created a four-dimensional CT (4DCT) dataset. The datasets were reconstructed and deformation measured at various levels of the RVOT/PAs in both space and time. Section planes were either static or dynamic relative to the motion of the structures.

Results

4DCT enabled measurement and characterisation of in vivo 3D changes of patients’ RVOT/PA during the cardiac cycle. The studied patient population showed a wide range of RVOT/PA morphologies, sizes and dynamics that develop late after surgical repair of congenital heart disease. There were also significant differences in the measured cross-sectional areas of the structures between static and dynamic section planes (up to 150%, p < 0.05) secondary to large 3D displacements and rotations.

Conclusions

4DCT imaging data suggest high variability in RVOT/PA dynamics and significant errors in deformation measurements if 3D analysis is not carried out. These findings play an important role for the development of novel percutaneous approaches to pulmonary valve intervention.

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Acknowledgements

Philipp Bonhoeffer is a consultant of Medtronic and receives funding from them. The other authors declare that they have no conflict of interest. This work was supported by the Royal Academy of Engineering/EPSRC, the British Heart Foundation, the European Union – Health-e-Child initiative, the UK National Institute of Health Research, and the Foundation Leducq. None of the funding bodies or industrial partners had a role in analysis of data, results or conclusions of the study.

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Authors and Affiliations

  1. Cardiovascular Unit, UCL Institute of Child Health & Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK

    Silvia Schievano, Claudio Capelli, Carol Young, Philipp Lurz, Johannes Nordmeyer, Catherine Owens, Philipp Bonhoeffer & Andrew M. Taylor

Authors
  1. Silvia Schievano
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  2. Claudio Capelli
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  3. Carol Young
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  4. Philipp Lurz
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  5. Johannes Nordmeyer
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  6. Catherine Owens
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  7. Philipp Bonhoeffer
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  8. Andrew M. Taylor
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Corresponding author

Correspondence to Silvia Schievano.

Electronic supplementary material

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Movie 1

3D blood volume reconstruction over the cardiac cycle from 4DCT images of the 12 patients studied. (MPG 1054 kb)

Movie 2

Example of static plane and dynamic sections in a selected patient during the cardiac cycle. (MPG 698 kb)

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Schievano, S., Capelli, C., Young, C. et al. Four-dimensional computed tomography: a method of assessing right ventricular outflow tract and pulmonary artery deformations throughout the cardiac cycle. Eur Radiol 21, 36–45 (2011). https://doi.org/10.1007/s00330-010-1913-5

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  • DOI: https://doi.org/10.1007/s00330-010-1913-5

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