A simple method to estimate cardiac function during routine multi-row detector CT exams |
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Authors: | Piet K Vanhoenacker Lieven R Van Hoe |
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Institution: | (1) Department of Radiology and Imaging, OLV Ziekenhuis Aalst, 9300 Aalst, Belgium |
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Abstract: | Cardiac dysfunction may be suggested at computed tomography (CT) exams by the presence of morphological abnormalities such
as cardiac enlargement and thickening of the pulmonary interlobular septa. However, these morphological signs are non specific.
We evaluated whether right-to-left cardiac transit time of contrast during single-level timing scans could predict the cardiac
output and ejection fraction. In a consecutive group of 100 patients referred for body CT, a preliminary single-level study
was used to measure the right-to-left ventricular transit time of intravenously injected contrast medium. In all these patients,
the cardiac index (cardiac output corrected for body surface area, CI) and ejection fraction (EF) were calculated using cardiac
magnetic resonance imaging (CMR). Data of the first half (50 patients, group A) were used to establish a method and concept
to predict the cardiac index and ejection fraction with CT. The method was validated in the next half (50 patients, group
B) by comparing the predicted CT results with those obtained with CMR. There was a good correlation of the observed CI with
CMR and observed transit time on CT in group B (P < 0.05; R2 0.70 ). Functional CT estimates of CI and EF in group B correlated well with the CMR results for CI and EF (P < 0.05; R2 0.66 for CI and P < 0.05; R2 0.49 for EF). The presence of a right-to-left ventricular transit time of more than 10.5 s indicated cardiac dysfunction
with a specificity and positive predictive value of 100%. Right-to-left transit time obtained during routine body CT exams
can provide valuable physiological information on global cardiac function. |
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Keywords: | Tomography Spiral computed Cardiac output Contrast media |
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