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KMID : 1149520190030030061
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Cardiovasclar Imaging Asia
2019 Volume.3 No. 3 p.61 ~ p.67
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Volumetric Severity Assessment of Ebstein Anomaly Using Three-Dimensional Cardiac CT: A Feasibility Study
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Goo Hyun-Woo
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Abstract
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Objective: The purpose of this study was to demonstrate the feasibility of using cardiac CT to perform volumetric severity assessment of the Ebstein anomaly.
Materials and Methods: Six children with Ebstein anomaly were included. We used cardiac CT to measure the delineated tricuspid valve, streak artifacts, and contrast enhancement heterogeneity. Cardiac CT data were used to quantify the volumes of all of the cardiac chambers, including the atrial and functional right ventricle (RV). In addition, the functional RV (fRV) fraction, fRV/left ventricle (LV) volume ratio, and total right/left-volume index were calculated. The volume-based CT severity index was compared using area-based echocardiographic and CT severity indices.
Results: All of the patients had grade 3 or 4 extent of delineation of the malformed tricuspid valve and streak artifacts. In one case, the right atrium had image noise [126.7 Hounsfield units (HU)] that was >50 HU, while all others demonstrated image noise <50 HU. This image quality was appropriate to make all of the volumetric measurements. The RV volumes were enlarged in 83.3% (5/6) of the cases. The fRV fraction was 60.8?61.5%. The fRV/LV volume ratio and total right/left-volume index were 2.0±1.4 and 3.5±1.5, respectively. There was a smaller difference (0.2±0.1) between the area-based and volume-based CT severity indices than there was in other comparisons. These parameters also had a higher concordance rate (83.3%, 5/6) in the severity grades.
Conclusion: Volumetric severity assessment using cardiac CT is feasible in Ebstein anomaly, and may be useful to characterize the disease's diverse phenotypes.
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KEYWORD
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Cardiac imaging technique, Ebstein anomaly, Multidetector computed tomography, Severity of illness index, Imaging, three-dimensional, Ventricular function
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