Assessment of right ventricular function by 16-detector-row CT: comparison with magnetic resonance imaging

Koch, Karl Christian; Oellig, F.; Oberholzer, K; Bender, Pablo Martin; Kunz, Patrik; Mildenberger, P.; Hake, U; Kreitner, Karl‐Friedrich; Thelen, M.

doi:10.1007/s00330-004-2543-6

Cited by 96 publications

(95 citation statements)

References 25 publications

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“…Although the current study provides no direct intra-patient comparison between CMR and CT, previous studies demonstrated adequate correlation of RV volumes and function measured with 64-slice CT and those with CMR [7]. However, the more limited temporal resolution of 16-slice CT resulted in a systemic over-estimation of RV end-systolic volume [8].As also addressed by Winters et al, CT is associated with radiation and iodine contrast material. The radiation dose of 14 mSv in the current study is substantial, especially for relatively young patients who are likely to receive additional examinations and treatments associated with radiation.…”

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confidence: 59%

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Tailor-made right ventricular imaging

Meijs

2012

Neth Heart J

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Right ventricular (RV) performance has a major role in the clinical status and prognosis of patients with congenital heart disease, especially in patients with a systemic right ventricle such as patients with congenitally corrected transposition of the great arteries (TGA) or with TGA corrected by a Mustard or Senning operation.Quantification of RV function is challenging for several reasons. Especially in echocardiography, the anterior position of the right ventricle in the chest causes near-field artifacts, which may preclude visualisation of the RV apex. Also, the complex morphology of the right ventricle makes an estimation of volumes based on two-dimensional (2D) measurements unreliable. Thirdly, exact delineation of the thin and highly trabecularised RV wall is difficult.Several modalities are available to assess RV function, of which cardiac magnetic resonance imaging (CMR) and echocardiography are most frequently used in clinical practice. CMR is considered the standard of reference, yet CMR is more costly and less widely available than echocardiography. RV volume measurements by 2D echocardiography correlate poorly with CMR [1]. Strain and strain-rate imaging provides an accurate, yet indirect, assessment of RV myocardial performance [2]. Three-dimensional echocardiography provides more accurate RV volume measurements than 2D echocardiography, yet compared with CMR it consistently underestimates RV volume [3][4][5]. This is probably due to incomplete depiction of the right ventricle. Also, in 3D echocardiography image quality was insufficient in approximately one fourth of patients [3][4][5].CMR, on the other hand, is contraindicated in patients with a defibrillator or an MRI-unsafe pacemaker. Therefore, in the present issue, Winter and colleagues studied whether CT may be an alternative to CMR for the determination of RV volumes and function in TGA patients with a contraindication to CMR[6]. They studied 35 TGA patients; of these patients 20 underwent CMR to measure RV volumes and ejection fraction. In the remaining 15 patients, in whom CMR was contraindicated due to the presence of a pacemaker or defibrillator, RV volumes and ejection fraction were determined by CT. The authors found that the intra-and interobserver variability of RV volumes and ejection fraction measured with CT were higher compared with those with CMR. However, except for RV stroke volume these differences in variability were not statistically significant. Although the current study provides no direct intra-patient comparison between CMR and CT, previous studies demonstrated adequate correlation of RV volumes and function measured with 64-slice CT and those with CMR [7]. However, the more limited temporal resolution of 16-slice CT resulted in a systemic over-estimation of RV end-systolic volume [8].As also addressed by Winters et al., CT is associated with radiation and iodine contrast material. The radiation dose of 14 mSv in the current study is substantial, especially for relatively young patients who are likely to receive additi...

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confidence: 59%

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confidence: 71%

Tailor-made right ventricular imaging

Meijs

2012

Neth Heart J

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“…With reconstruction of multiple slices of the short axis of the ventricle at 10 instances evenly distributed across the cardiac cycle, left-and right-ventricular function can both be analyzed. Quantitative estimations of ventricular function by MSCT have demonstrated good accuracy, with calculated ejection fractions within 10% of those obtained by means of MRI, 21,22 which is considered the most accurate method. Moreover, MSCT also detects abnormalities in wall motion.…”

Section: Multiple-slice Spiral Computed Tomographymentioning

confidence: 82%

New imaging techniques for diagnosing coronary artery disease

Escolar

Weigold

Fuisz

et al. 2006

CMAJ

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I nvasive coronary angiography is the standard clinical means for depicting the coronary arteries and is the "gold standard" for diagnosing coronary artery disease (CAD). Since its implementation over 30 years ago, more than 2 million coronary angiograms have been made yearly in North America. Coronary angiography requires high-level technical expertise and technology, which makes it relatively expensive and limits it to a select population. Angiography also has its limitations, since only the lumen is displayed ("luminology") and the information it provides about the coronary plaque is not extensive. However, new tomographic methods for cardiovascular imaging such as intravascular ultrasonography (IVUS), coronary CT angiography and MRI can assess the atherosclerotic plaques responsible for early, "silent" CAD. In this article, we review the current and potential future clinical applications of these 3 tools for the visual detection of atherosclerotic CAD. Intravascular ultrasonographyIVUS has become a powerful complementary tool to measure and characterize coronary vessels and atherosclerotic plaques. An invasive procedure, IVUS produces images with a small ultrasound transducer mounted on a catheter similar to the standard catheters employed in coronary angioplasty. The catheter is advanced over the wire inside the coronary artery until it reaches a position distal to the segment to be studied. A series of tomographic images of the coronary artery are obtained as the catheter is slowly pulled back. Each IVUS image displays a 360°cross-sectional view of the layers of the coronary artery (intima, media and adventitia) as well as the lumen (Fig. 1A,B). Modern devices can perform 3-dimensional reconstructions online that provide information about the length, volume and reference landmarks of a plaque.Standard radiographic coronary angiography provides a single-plane "shadow" of the vascular lumen; its ability to accurately and reproducibly measure the degree of stenosis and to characterize plaque morphology is limited.1-3 Extensive experience in our and other centres has shown that IVUS is a safe, accurate and reproducible alternative method for assessing the severity and morphology of lesions.4,5 The types of plaques detectable by IVUS are summarized in Box 1. Clinical useThe best-studied clinical application of IVUS is in the placement of stents into coronary vessels (Fig. 1C,D, Fig. 2, Fig. 3). Stenting has revolutionized the treatment of atherosclerotic CAD. Restenosis inside the stent, which occurs in 5%-20% of cases (depending on the complexity of the lesion and underlying risk factors), nevertheless remains a major shortcoming. IVUS has played an important role in the understanding of stent failures.In-stent restenosis is typically caused by neointimal hyperplasia: new fibrotic tissue that grows inside the stent and obstructs the lumen. Serial IVUS studies performed in cases of bare-metal stent failure have shown that underexpansion of the stent is an important cause of early failure.6 If the stent is poorl...

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“…Cardiac CT also provides adequate visualization of right ventricular (RV) volume and function, with studies showing good correlation of RV functional parameters obtained by CCT with MRI, angiography and echocardiography. [25,26] An important caveat to CCT's ability to workup cardiac function is that prospective ECG gating is increasingly employed in order to reduce the amount of radiation exposure, and it is not possible to assess ejection fraction and wall motion with this technique. In addition, the temporal resolution of CCT is limited compared to MRI and may impair its ability to obtain images in patients with higher heart rates.…”

Section: Heart Failure (Impaired Systolic Function)mentioning

confidence: 99%

Utility of cardiac computed tomography to identify arrhythmia substrates for ventricular tachycardia and sudden cardiac death

Lee

Budoff

Girsky

2016

JBGC

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Sudden cardiac death (SCD) is the leading cause of death in the U.S., and many of these events are attributable to malignant ventricular arrhythmias such as sustained ventricular tachycardia (VT). Most of the efforts to identify arrhythmia precipitants in these patients are based on imaging to look for myocardial or coronary artery disease. As advances in cardiac computed tomography (CCT) are made, it has demonstrated its usefulness in identifying structural intracardiac pathology and measuring parameters of cardiac anatomy and function. In this article we review the different etiologies of VT/SCD that are identifiable by CCT, and its potential usefulness in the workup for VT/SCD.

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Assessment of right ventricular function by 16-detector-row CT: comparison with magnetic resonance imaging

Cited by 96 publications

References 25 publications

Tailor-made right ventricular imaging

Tailor-made right ventricular imaging

New imaging techniques for diagnosing coronary artery disease

Utility of cardiac computed tomography to identify arrhythmia substrates for ventricular tachycardia and sudden cardiac death

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