Accuracy and variability of right ventricular volumes and mass assessed by dual-source computed tomography: influence of slice orientation in comparison to magnetic resonance imaging

Jensen, Christoph J; Wolf, Alexander; Eberle, Holger C; Forsting, Michael; Naßenstein, Kai; Lauenstein, Thomas C.; Sabin, Georg; Bruder, Oliver; Schlosser, Thomas

doi:10.1007/s00330-011-2207-2

Cited by 9 publications

(7 citation statements)

References 36 publications

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“…Subsequently, cvMRI was done later than TEE in the majority of study patients. Fifth, although excellent inter-and intraobserver agreement was demonstrated by the cardiac MRI core laboratory in Essen, Germany, 30 this assessment was not part of the CaMRISS protocol. Finally, the definitive risk of recurrent stroke in stroke patients with extended transmural myocardial scarring and subsequent hypo-or akinesia in ≥3 wall segments has to be assessed in a large prospective trial.…”

Section: Discussionmentioning

confidence: 98%

Feasibility and Diagnostic Value of Cardiovascular Magnetic Resonance Imaging After Acute Ischemic Stroke of Undetermined Origin

Hæusler

Wollboldt

Bentheim

et al. 2017

Stroke

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E tiologic work-up is essential in patients with acute ischemic stroke to optimize secondary stroke prevention. According to international guidelines, state-of-the-art diagnostic work-up includes brain imaging, ultrasound of brainsupplying arteries, echocardiography, ECG monitoring, and distinct blood tests.1,2 However, stroke etiology remains undetermined (cryptogenic) in about 25% of all acute ischemic stroke patients. 3 Apart from nonpermanent atrial fibrillation (AF), 4 ventricular noncompaction, left atrial or ventricular thrombi, mitral or aortic valve stenosis, and ulcerated aortic arch atherosclerotic plaques are associated with a moderate to high embolic stroke risk and were found in a substantial part Background and Purpose-Etiology of acute ischemic stroke remains undetermined (cryptogenic) in about 25% of patients after state-of-the-art diagnostic work-up. Methods-One-hundred and three patients with magnetic resonance imaging (MRI)-proven acute ischemic stroke of undetermined origin were prospectively enrolled and underwent 3-T cardiac MRI and magnetic resonance angiography of the aortic arch in addition to state-of-the-art diagnostic work-up, including transesophageal echocardiography (TEE). We analyzed the feasibility, diagnostic accuracy, and added value of cardiovascular MRI (cvMRI) compared with TEE for detecting sources of stroke. Despite interstudy variations on the definition and prevalence of (potential) embolic sources, current guidelines recommend diagnostic echocardiography in stroke patients. 2Although noninvasive transthoracic echocardiography (TTE) is easy to use, semi-invasive transesophageal echocardiography (TEE) is typically needed to visualize the left atrium, left atrial appendage, atrial shunts, and the aortic arch-all of them potential sources of embolism.6 Serious complications during TEE rarely occur.7 However, required preprocedural fasting, periprocedural conscious sedation, and the demand of highly skilled personnel limit its availability and cause in-hospital delays. 8 In consequence, TEE is not routinely performed in (cryptogenic) stroke patients, even in high-income countries.9 Subsequently, assessment of potential embolic sources of ischemic stroke is often inappropriate in clinical practice. Although cardiac computed tomography could add information about stroke etiology, 10 the main disadvantage of this approach is the exposure to radiation. Cardiac magnetic resonance imaging (MRI) has been increasingly often implemented in the clinical diagnostic workflow of various cardiac diseases over the past 10 years and allows for accurate biventricular functional analysis and tissue characterization. Cardiac MRI is now considered the gold standard to assess cardiac tumors, myocarditis, cardiomyopathies, and subclinical coronary heart disease. 11,12 In addition, cardiac MRI has demonstrated feasibility of detecting atrial or ventricular thrombi, 13 aortic atherosclerotic plaques, 14,15 or left atrial enlargement. 16,17 Moreover, cardiac MRI is superior to echocardiography on d...

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Section: Discussionmentioning

confidence: 98%

Feasibility and Diagnostic Value of Cardiovascular Magnetic Resonance Imaging After Acute Ischemic Stroke of Undetermined Origin

Hæusler

Wollboldt

Bentheim

et al. 2017

Stroke

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“…Several other studies 21,22,28,29 reported differences in right ventricular volumes, while ejection fraction remained unaffected. In contrast, Alfakih et al showed an even larger ejection fraction in the axial orientation.…”

Section: Discussionmentioning

confidence: 89%

Evaluating the Systemic Right Ventricle by Cardiovascular Magnetic Resonance: Short Axis or Axial Slices?

et al. 2014

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“…The number of CT slices was ≥ 64 (15,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) in 13 studies and < 64 in 7 studies. In studies with ≥ 64 CT slices (6, 11-14, 16, 17), EDV and ESV showed a lower weighted bias and narrower LOA than in studies with < 64 CT slices.…”

Section: Subgroup Analysismentioning

confidence: 97%

“…Table 1 and Supplementary Table 1 summarize the study characteristics and details of image acquisition and RV analysis method in the included studies. The radiation dose from cardiac CT was 2.7-20 mSv in the ten included studies (11,15,16,(20)(21)(22)(24)(25)(26)(27).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…With the recent improvements in the temporal and spatial resolution of computed tomography (CT) scanners, cardiac CT can be used to assess RV volume and function (10). Previous studies that compared CT measurements of RV volume and function with CMRI as the reference standard showed variable results regarding the agreement between cardiac CT and CMRI (6,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). These variable results may be attributable to the differences in RV segmentation methods in cardiac CT and MRI; for example, two-dimensional (2D)-vs. threedimensional (3D)-based methods, manual vs. semiautomatic vs. automatic segmentation, and threshold-based segmentation vs. simplified contouring (30)(31)(32)(33).…”

Section: Introductionmentioning

confidence: 99%

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Cardiac CT for Measurement of Right Ventricular Volume and Function in Comparison with Cardiac MRI: A Meta-Analysis

et al. 2020

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Objective: We performed a meta-analysis to evaluate the agreement of cardiac computed tomography (CT) with cardiac magnetic resonance imaging (CMRI) in the assessment of right ventricle (RV) volume and functional parameters. Materials and Methods: PubMed, EMBASE, and Cochrane library were systematically searched for studies that compared CT with CMRI as the reference standard for measurement of the following RV parameters: end-diastolic volume (EDV), endsystolic volume (ESV), stroke volume (SV), or ejection fraction (EF). Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and correlation coefficient (r) between CT and CMRI. Heterogeneity was also assessed. Subgroup analyses were performed based on the probable factors affecting measurement of RV volume: CT contrast protocol, number of CT slices, CT reconstruction interval, CT volumetry, and segmentation methods. Results: A total of 766 patients from 20 studies were included. Pooled bias and LOA were 3.1 mL (-5.7 to 11.8 mL), 3.6 mL (-4.0 to 11.2 mL),-0.4 mL (5.7 to 5.0 mL), and-1.8% (-5.7 to 2.2%) for EDV, ESV, SV, and EF, respectively. Pooled correlation coefficients were very strong for the RV parameters (r = 0.87-0.93). Heterogeneity was observed in the studies (I 2 > 50%, p < 0.1). In the subgroup analysis, an RV-dedicated contrast protocol, ≥ 64 CT slices, CT volumetry with the Simpson's method, and inclusion of the papillary muscle and trabeculation had a lower pooled bias and narrower LOA. Conclusion: Cardiac CT accurately measures RV volume and function, with an acceptable range of bias and LOA and strong correlation with CMRI findings. The RV-dedicated CT contrast protocol, ≥ 64 CT slices, and use of the same CT volumetry method as CMRI can improve agreement with CMRI.

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Accuracy and variability of right ventricular volumes and mass assessed by dual-source computed tomography: influence of slice orientation in comparison to magnetic resonance imaging

Cited by 9 publications

References 36 publications

Feasibility and Diagnostic Value of Cardiovascular Magnetic Resonance Imaging After Acute Ischemic Stroke of Undetermined Origin

Feasibility and Diagnostic Value of Cardiovascular Magnetic Resonance Imaging After Acute Ischemic Stroke of Undetermined Origin

Evaluating the Systemic Right Ventricle by Cardiovascular Magnetic Resonance: Short Axis or Axial Slices?

Cardiac CT for Measurement of Right Ventricular Volume and Function in Comparison with Cardiac MRI: A Meta-Analysis

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