ROLE OF DUAL-SOURCE MULTIDETECTOR COMPUTED TOMOGRAPHY IN ASSESSMENT OF LEFT VENTRICULAR GLOBAL AND REGIONAL FUNCTION IN COMPARISON TO ECHOCARDIOGRAPHY

Abstract

Aims: Multidetector computed tomography (MDCT) is used largely to evaluate the coronary arteries. Currently, MDCT is being considered for the assessment of the left ventricular function. The aim of this study is to evaluate the diagnostic accuracy of MDCT in assessment of global and regional left ventricular (LV) function in comparison to echocardiography.
Methods: Sixty four-slice multidetector computed tomography studies evaluating the global LV function and regional wall motion abnormalities (RWMA) of 30 consecutive patients were compared to their echocardiographic estimated LV ejection fraction and RWMA.
Results: Global LV function evaluation demonstrated a highly significant strong positive correlation (r =0.966, p< 0.0001) between both techniques, Bland–Altman analysis showed good agreement between both modalities with mean difference of -1.8%±2.5% (mean±2STD). For RWMA evaluation good agreement was shown between the two techniques, with 95.9% (489 of 510 segments) of the segments scored identically with use of both modalities. Agreement with the individual grading for the regional wall motion (normokinesia, hypokinesia, akinesia and dyskinesia) were 96%, 94%, 92%, and 100% respectively. MDCT had a sensitivity of 96%, a specificity of 96% and an accuracy of 96% when compared to the two dimensional transthoracic echocardiography using the 17-segment approach.
Conclusion: this study showed the feasibility of assessing global and regional LV function and LV volumes with Dual-Source 64-slice MDCT in patients with coronary artery disease during same data acquisition for noninvasive evaluation of the coronary arteries.
Keywords: Multidetector CT, global LV function, Regional wall motion, Ischemic heart disease, Echocardiography