Wieland Staab MD, Presenter: Nothing to Disclose

Jan Martin Sohns MD, Abstract Co-Author: Nothing to Disclose

Martin Fasshauer MD, Abstract Co-Author: Nothing to Disclose

Christian Sohns, Abstract Co-Author: Nothing to Disclose

Christina Unterberg-Buchwald, Abstract Co-Author: Nothing to Disclose

Joachim Lotz MD, Abstract Co-Author: Research Cooperation, Siemens AG

Using a split-bolus single phase cardiac-CT angiography (CCTA) in patients prior PVI, CT Datasets were evaluated in left ventricular end-systolic (LVES) (39±4 % RR-interval) and left ventricular end-diastolic (LVED) (77±5 % RR-interval) cardiac cycle. Aim of the study was to investigate diagnostic accuracy of CCTA between cardiac cycles, intra/- interobserver variability’s as well as comparing acquired volumetric and diametric datasets.

182 consecutive Patients with drug refractory AF scheduled for PVI (62.6 % male, mean age 64.1±10.2 years) underwent routine pre-procedural evaluation including TEE and CCTA for evaluation of LA/LAA anatomy and thrombus formation. Here, qualitative and quantitative analysis (using LA/LAA ratio) was performed. Volumetric measurements in LVES and LVED were carried out according to the Simpson`s method. Intra- and interobserver variability was observed in all acquired datasets and both reconstruction intervals.  

14 out of 182 patients (7.7%) showed filling defects of the LAA in CCTA. End-systolic volumes (LA/LAA) measured in 30 patients without filling defects and all 14 with filling defects were significantly larger ( p < 0.01) than in end-diastolic phase. Patients with filling defects showed significantly larger LA volumes than in patients without ( 193.07 ± 9.77 ml/m² vs 171.87 ± 26.85 ml/m² ; p< 0.01). Qualitative analysis was inferior to quantitative analysis using LA/LAA Ratio (< 0.5; accuracy : 100%,88%,100%,99% vs 100%). Intra/-interobserver variability was lower in end-systolic vs end-diastolic reconstruction interval (  = 0.942 vs 0.891).

For evaluating CCTA datasets in patients prior PVI, the LVES (39±4 % RR-interval) reconstruction interval is recommended due to significantly larger LA/LAA volumes and lower intra/- interobserver variability’s.

The LVES interval is recommended for reconstructing CCTA Datasets in patients referred for pulmonary vein intervention due to significantly larger LA/LAA diameters / volumes (p< 0.01) and lower intra/- interobserver variability’s

Staab, W, Sohns, J, Fasshauer, M, Sohns, C, Unterberg-Buchwald, C, Lotz, J, Comparison of End-diastolic versus End-systolic Cardiac-computed Tomography Reconstruction Interval in Patients prior PVI.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007728.html