Sixty-Four-Slice Multidetector Computed Tomography for Preoperative Evaluation of Left Ventricular Function and Mass in Patients with Mitral Regurgitation: Comparison with Magnetic Resonance Imaging and Echocardiography

OBJECTIVES: Quantitative values of left ventricular (LV) function and muscle mass in patients with mitral regurgitation are independent predictors of cardiac morbidity and mortality. The aim of this study was to prospectively evaluate whether 64-MDCT can assess the LV function in patients with mitral regurgitation with high accuracy when compared with the MRI and echocardiography results.

METHODS: Fifty-one patients with mitral regurgitation underwent retrospectively ECG-gated 64-MDCT, echocardiography, and MRI for assessing the global ventricular function. End-diastolic and end-systolic volume, stroke volume, ejection fraction, and mass were measured on 64-MDCT and echocardiography, and compared with the results measured on MRI which served as the reference standard. Intertechnique agreement was tested by using Pearson's correlation and Bland-Altman analyses.

RESULTS: No significant differences were revealed in calculated LV function and mass between the 64-MDCT and MRI (paired t test, p = 0.07-0.53). Pearson's correlation analysis showed the functional parameters and mass correlated closely between the 64-MDCT and MRI (r = 0.89-0.96, p < 0.001). When compared with MRI, echocardiography underestimated the volumetric parameters of LV (paired t test, p = 0.0003-0.004), but significantly overestimated the EF values (p = 0.003), and moderate correlations of functional parameters were obtained (r = 0.78, 0.60, 0.81, and 0.62, respectively).

CONCLUSIONS: ECG-gated 64-MDCT allows for accurate and reliable assessment of LV function in patients with mitral regurgitation, whereas LV volumes measured by two-dimensional echocardiography were underestimated and the ejection fraction was overestimated when compared with those achieved by using MRI.

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Posted in Computed Tomography, Echo, Magnetic Resonance Imaging and tagged , , , , , .

2 Comments

  1. This is an excellent study using CT for non-coronary purposes. There continues to be more interest in using CT for purposes outside the coronary artery tree due to its high spatial resolution. As radiation exposure continues to go down, the trend towards increased use of CT will likely continue.

  2. A very well designed study. However, should there be a clinical concern when the intra- and inter-observer variability coefficients for EF are 8.1 and 9.7%? Is the clinical management of a patient the same when his EF is 45% rather than 53.1%?

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