Feasibility of left ventricular systolic function assessment with two-phase reconstruction of retrospective ECG-gated 256-slice CT:correlation with Echocardiography

SUN Hong-liang; ZOUYing-hua; XUYan-yan; WANG Wu

Abstract：Objective To demonstrate the clinical feasibility of retrospective ECG-gated 256-slice CT with two-phase re-construction to evaluate left ventricular volume and systolic function in comparison with 2-dimensional Echocardiography . Methods Sixty-two patients who underwent coronary CTA and Echocardiography were included in the study .The left ventricular end-diastolic (LVEDV ) and end-systolic volumes (LVESV ) ,stroke volume (LVSV ) ,and ejection fraction (LVEF) were measured using two different methods of cardiac CT and echocardiography .The first method was multi-phase reconstruction method with original cardiac CT images in 13 cardiac phases over the cardiac cycle (every 5% incre-ments of the R-R interval) .The second method was two-phase reconstruction method based on retrospective ECG trigge-ring :the end-diastolic phase was reconstructed when the reconstruction window was located at the starting point of the QRS complex on ECG .The end-systolic phase was reconstructed when the reconstruction window was located halfway in the ascending T wave on ECG .The left ventricular functional parameters determined by the two reconstruction methods were compared .The results respectively obtained from CT and Echocardiography were also compared .All data were ana-lyzed by MedCalc V11 .4 .2 commercial software using Pearson correlation analyses and Bland-Altman analyses .A value of P <0 .05 was considered statistically significant .Results Data from 62 patients were used for this study .The left ven-tricular functional parameters showed good correlation between cardiac CT and Echocardiography (0 .838< r <0 .997) . LVEDV ,LVESV ,LVSV and LVEF differences of two-phase CT and Echocardiography (6 .9 ± 8 .9) ml/m2 ,(0 .9 ± 2 .6) ml/m2 ,(6 .0 ± 9 .0) ml/m2 ,(1 .1 ± 3 .6)% showed less than those of multi-phase CT and Echocardiography (-7 .2 ± 16 .5) ml/m2 ,(5 .4 ± 13 .1) ml/m2 ,(-12 .6 ± 17 .2) ml/m2 ,(-8 .5 ± 10 .9)% .Conclusion The two-phase reconstruction of ret-rospective ECG-gated 256-slice CT showed good correlations for LVEDV ,LVESV ,LVSV ,LVEF compared with Echo-cardiography .The two-phase reconstruction method on cardiac CT is technically feasible ,relatively objective and more time-effective ,which can provide useful information about left ventricular systolic function for clinical diagnosis .