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KMID : 0880420170180040632
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Korean Journal of Radiology
2017 Volume.18 No. 4 p.632 ~ p.642
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Estimation of Diastolic Filling Pressure with Cardiac CT in Comparison with Echocardiography Using Tissue Doppler Imaging: Determination of Optimal CT Reconstruction Parameters
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Hwang Ji-Sun
Lee Heon
Lee Bo-Ra
Lee Soo-Jeong
Jou Sung-Shick
Lim Hyun-Kyung
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Abstract
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Objective: To determine the optimal CT image reconstruction parameters for the measurement of early transmitral peak velocity (E), early peak mitral septal tissue velocity (E′), and E / E′.
Materials and Methods: Forty-six patients underwent simultaneous cardiac CT and echocardiography on the same day. Four CT datasets were reconstructed with a slice thickness/interval of 0.9/0.9 mm or 3/3 mm at 10 (10% RR-interval) or 20 (5% RR-interval) RR-intervals. The E was calculated by dividing the peak transmitral flow (mL/s) by the corresponding mitral valve area (cm2). E′ was calculated from the changes in the left ventricular length per cardiac phase. E / E′ was then estimated and compared with that from echocardiography.
Results: For assessment of E / E′, CT and echocardiography were more strongly correlated (p < 0.05) with a slice thickness of 0.9 mm and 5% RR-interval (r = 0.77) than with 3 mm or 10% RR-interval. The diagnostic accuracy of predicting elevated filling pressure (E / E′ ≥ 13, n = 14) was better with a slice thickness of 0.9 mm and 5% RR-interval (87.0%) than with 0.9 mm and 10% RR-interval (71.7%) (p = 0.123) and significantly higher than that with a slice thickness of 3 mm with 5% (67.4%) and 10% RR-interval (63.0%), (p < 0.05), respectively.
Conclusion: Data reconstruction with a slice thickness of 0.9 mm at 5% RR-interval is superior to that with a slice thickness of 3 mm or 10% RR-interval in terms of the correlation of E / E′ between CT and echocardiography. Thin slices and frequent sampling also allow for more accurate prediction of elevated filling pressure.
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KEYWORD
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Cardiac CT, Echocardiography, Tissue Doppler, Ventricular function, Diastolic function, Left ventricle
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