Aims and objectives
Cardiac CT has been introduced in clinical practice as a valuable tool for non-invasive evaluation of coronary anatomy,
especially in heart failure settings (Class IIb indication in 2016 ESC Guidelines).
Moreover cardiac CT has been recently described as a useful tool for a comprehensive assessment of cardiac anatomy and function,
other than the sole evaluation of coronary anatomy.
More specifically,
computed tomography delayed enhancement for the identification of myocardial fibrosis have been demonstrated to be feasible and accurate when compared to cardiac MRI evaluation.
However,...
Methods and materials
A consecutive cohort of patients with newly diagnosed LVD (left ventricular disfunction) (LVEF<50%) and clinical indicated MRI will be screened.
Exclusion criteria will be contraindications to contrast agents and impaired renal function (creatinine clearance <60 ml/min).
Cardiac CT will be performed per protocol within ±10 days from MRI.
CCTAs will be performed with last generation CT scanner with whole heart coverage and gantry rotation time of 280 msec.
A first CT scan will be performed using bolus tracking technique and timing for the scan will...
Results
40 patients have been enrolled form January 2018 and September 2018.
Biventricular volumes and ejection fractions (EFs) were similar when evaluated at CT and CMR.
Particularly,
left ventricle EF was similar between CT (35.9 ± 9.7%) and MRI (35 ± 9.8%,
p=0.2055).
Right ventricle end diastolic volume (EDV) was slightly overestimated by CT (178.7 ± 55.7 mL vs.
155.4 ± 54.1 mL,
CT vs.
CMR,
respectively,
p=0.0048).
Thirty patients showed late enhancement (LE) consistent with myocardial fibrosis at CMR,
of whom 97% (29/30) were correctly...
Conclusion
Cardiac CT appears to be feasible and accurate in the evaluation of newly diagnosed LVD in comparison with CMR and can be considered as an alternative technique in patients with contraindication to MRI.
Radiation dose for fibrosis assessment alone was negligible (0.84 ± 0.2 mSv).
References
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Usinger L,
Kristensen TS,
Abdulla J.
Accuracy of multi-slice computed tomography for measurement of left ventricular ejection fraction compared with cardiac magnetic resonance imaging and two-dimensional transthoracic echocardiography: a systematic review and meta-analysis.
Eur J Radiol. 2012 May;81(5):e757-62.
2. 2.Bakos Z,
Markstad H,
Ostenfeld E,
Carlsson M,
Roijer A,
Borgquist R.
Combined preoperative information using a bullseye plot from speckle tracking echocardiography,
cardiac CT scan,
and MRI scan: targeted left ventricular lead implantation in patients receiving cardiac resynchronization therapy.
Eur Heart J...