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Evaluation of biventricular ejection fraction with ECG-gated 16-slice CT: preliminary findings in acute pulmonary embolism in comparison with radionuclide ventriculography

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Abstract

This study aimed to assess the feasibility of cardiac global function evaluation during a whole-chest multi-slice CT (MSCT) acquisition in patients referred for suspicion of pulmonary embolism (PE), and to compare the results with planar equilibrium radionuclide ventriculography (ERNA). Ten consecutive haemodynamically stable patients (six female, four male; mean age 69.7 years; heart rate 65–99 bpm) with suspicion of PE underwent an MSCT and ERNA within a 6 h period. CT acquisition was performed after contrast medium injection by using 16×1.5 mm collimation and retrospective ECG gating. Left ventricular (LVEF) and right ventricular (RVEF) ejection fractions were calculated using dedicated three-dimensional software. Relationships between measurements obtained with MSCT and ERNA were assessed using linear regression analysis and reliability of MSCT was assessed with intra-class correlation coefficient. Bland–Altman analysis was performed to calculate limits of agreement between MSCT and ERNA. MSCT was performed successfully in ten patients with a mean acquisition time of 16.5±2.8 s. Functional cardiac evaluation was possible on CT for all patients except for one due to poor opacification of right ventricle. Linear regression analysis showed a good correlation between MSCT and ERNA for the LVEF (R=0.91) and the RVEF (R=0.89) measurements. Intra-class correlation was superior for LVEF (0.92) than for the RVEF (0.68). Bland–Altman plots demonstrated that MSCT substantially overestimated the ERNA RVEF. Morphological CT data demonstrated PE in four of ten of patients and alternative diagnoses in five of ten patients. Our study reveals that MSCT with retrospective ECG gating may provide in one modality a morphological and a functional cardiopulmonary evaluation. Comparison with ERNA demonstrated a good correlation for both ventricular ejection fractions.

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Authors and Affiliations

  1. Department of Medical Imaging, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Av. Hippocrate, 10, 1200, Brussels, Belgium

    Emmanuel Coche, Louis Goncette & Baudouin Maldague

  2. Philips Medical Systems, Cleveland, OH, USA

    Alain Vlassenbroek

  3. Department of Nuclear Medicine, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Av. Hippocrate, 10, 1200, Brussels, Belgium

    Véronique Roelants

  4. Public Health, Catholic University of Louvain, Brussels, Belgium

    William D’Hoore

  5. Department of Emergency Medicine, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Av. Hippocrate, 10, 1200, Brussels, Belgium

    Franck Verschuren

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  1. Emmanuel Coche
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Correspondence to Emmanuel Coche.

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Coche, E., Vlassenbroek, A., Roelants, V. et al. Evaluation of biventricular ejection fraction with ECG-gated 16-slice CT: preliminary findings in acute pulmonary embolism in comparison with radionuclide ventriculography. Eur Radiol 15, 1432–1440 (2005). https://doi.org/10.1007/s00330-004-2582-z

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  • DOI: https://doi.org/10.1007/s00330-004-2582-z

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