Masae Uehara MD, Presenter: Nothing to Disclose

Nobusada Funabashi MD, PhD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Takaoka MD, PhD, Abstract Co-Author: Nothing to Disclose

Akihisa Kataoka MD, Abstract Co-Author: Nothing to Disclose

Akiyo Takahashi PhD, Abstract Co-Author: Nothing to Disclose

Yoshio Kobayashi, Abstract Co-Author: Nothing to Disclose

To determine the utility of 320 slice CT for semiquantitative assessment of left ventricular (LV) wall motion, we acquired four dimensional (4D) heart images in subjects with asynergy of LV wall motion compared with transthoracic echocardiograms (TTE).

Retrospective review of ECG-gated 320 slice CT (Aquilion one, Toshiba Medical) of 22 subjects with asynergy of LV wall motion TTE (13 men, 9 female, mean age 68.5±10.5 years, 5 old myocardial infarction, 5 hypertrophic cardiomyopathy, 4 cardiac sarcoidosis, 2 takotsubo cardiomyopathy, 2 idiopathic arrhythmia, 1 dilated cardiomyopathy, 1 left ventricular non compaction, 1 drug-induced cardiomyopathy, and 1 idiopathic focal myocardial fibrosis).). Retrospective, ECG-gated, conventional enhanced 320-slice CT with tube current dose modulation was performed with a slice thickness of 0.5mm and a tube voltage of 120 kilovolts. CT images were reconstructed every 5% from 0-95% of the R-R interval of the ECG and 4D CT images were generated (Virtual Place, Aze) and LV wall motion was evaluated at 17 segments by American Society of Echocardiography criteria, by two experienced cardiologists, as was TTE. They analyzed TTE (IE-33, Philips) retrospectively, blinded to the CT results.

For 374 segments, kappa coefficients for the 5 classifications (aneurysmal, dyskinesis, akinesis, hypokinesis, normal kinesis) by the two assessors were 0.458 and 0.606 for CT and TTE data, respectively. Agreement between CT and TTE was 0.255 and 0.555 for the two observers. Kappa coefficients of the 7 classifications (aneurysmal, dyskinesis, akinesis, severe, moderate and mild hypokinesis, normal kinesis) by the two assessors were 0.367 and 0.439 for CT and TTE data, respectively. Agreement between CT and TTE was 0.158 and 0.423 for the two.

Semiquantitative LV wall motion assessment by 320 slice CT and TTE showed good inter-observer agreement but there were some discrepancies between 320 slice CT and TTE by the two assessors.

Retrospective ECG-gated conventional enhance 320 slice CT can assess LV wall motion semiquantitatively as well as coronary arteries. Images should be reconstructed every 5% from 0-95% of R-R interval.

Uehara, M, Funabashi, N, Takaoka, H, Kataoka, A, Takahashi, A, Kobayashi, Y, 320-Slice Computed Tomography Imaging-based Semiquantitative Assessment of Left Ventricular Wall Motion: Comparison with Transthoracic Echocardiography.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034657.html