RESUMO
UNLABELLED: The evaluation of Left ventricular function has both prognostic as well as therapeutic implications in patients with heart disease. Non-invasive coronary angiography with computed tomography using 16 slices (MDCT-16) allows to obtain images of the coronary anatomy due to its high spatial and temporal resolution, and also, to obtain data regarding Left ventricular function. The objective of this study was to correlate the use of MDCT-16 for the evaluation of the Left ventricular parameters using MRI as the Standard of reference. METHODS: MRI: Se A 1.5 Tesla GE CvI Scanner optimized for cardiovascular applications was used. Using an ECG gated steady state fast precession sequence (SSFP, Thickness 10 mm, Flip Angle 45, FOV 36 cm. NEX 1, Frequency 256, Phase 128, Partial FOV 0.75, 16VPS), 6 to 8 short axis images of from base to apex of the left ventricle were obtained. Tomography: Using a 16 slice Multidetector tomograph (GE Lightspeed) and using ECG synchronization, images of the heart were obtained after the administration of 80 mls. of no-ionic contrast. The images were reconstructed off-line to obtain from 6 to 8 slices in a similar fashion to that of MR. Both studies were independently analyzed by 2 operators who obtained the ventricular function data. Linear correlation and a Paired T Student test was used to analyze the data and was considered significant when p < 0.05. RESULTS: 20 consecutive patients were evaluated with MDCT-16 and MRI, 18 males, mean age 52 +/- 15 years. There was no significant difference among the measurements for cardiac CT and MRI of the end-diastolic volume (EDV) and end-sistolic volume (ESV), stroke volume (SV), LV Mass or LV ejection fraction (LVEF). CONCLUSION: This results show a high correlation among the clinically relevant ventricular function parameters evaluated by cardiovascular CT and MRI. This findings suggest that ventricular function can be successfully evaluated along with the coronary anatomy using MDCT-16.
Assuntos
Angiografia Coronária , Cardiopatias/diagnóstico , Angiografia por Ressonância Magnética , Tomografia Computadorizada por Raios X , Função Ventricular Esquerda , Humanos , Pessoa de Meia-IdadeRESUMO
La evaluación de parámetros funcionales del VI tienen implicaciones tanto pronosticas como terapéuticas en pacientes con cardiopatías. La angiotomografía coronaria con TCMD-16 permite obtener imágenes de la anatomía coronaria y por su alta resolución temporal y espacial, obtener datos de la función ventricular izquierda. El objetivo de este estudio fue correlacionar el uso de la TCMD-16 para la valoración de parámetros de función ventricular izquierda, utilizando la RM como estándar de referencia. Métodos: Resonancia: Se utilizó un resonador GE Cvl, de 1.5 Teslas optimizado para aplicaciones cardiovasculares. Mediante una secuencia de precesión rápida de estado fijo de manera sincronizada al ECG, (SSFP, Grosor de corte de 10 mm, Flip Angle 45, FOV 36 cm., NEX 1, Frecuencia 256, Fase 128, FOV parcial 0.75, 16 VPS), se obtuvieron de 6 a 8 imágenes en eje corto desde la base hasta el ápex del VI. Tomografía: Con un TCMD-16 GE Lightspeed sincronizado al ECG, se obtuvieron imágenes del corazón tras la administración de 80 mis. de contraste no-iónico. Las imágenes fueron reconstruidas para obtener de 6 a 8 cortes de manera similar a la RM. Ambos estudios fueron independientemente analizados por 2 operadores quienes obtuvieron los parámetros ventriculares. Las comparaciones fueron analizadas mediante la prueba de t de Student pareada y las correlaciones mediante regresión linear, considerando significativo cuando p<0.05. Resultados: Se evaluaron 20 pacientes consecutivos con TAC y RM cardiaca, 18 del sexo masculino, con una edad promedio de 52 ± 15 años. No hubo diferencia significativa entre las mediciones por TAC y por RM cardiaca del volumen telediastólico (VTD) y telesistólico (VTS) del VI, ni en el volumen latido (VL), la masa ventricular izquierda o la fracción de expulsión del VI (FEVI). Conclusión: Los resultados demuestran una alta correlación entre los parámetros de función ventricular sistólica clínicamente relevantes evaluados por TAC y por RM cardiaca. Esto sugiere que puede evaluarse la función ventricular en forma satisfactoria al mismo tiempo que se estudian estructuralmente las coronarias mediante el TCMD-16.
The evaluation of Left ventricular function has both prognostic as well as therapeutic implications in patients with heart disease. Non-invasive coronary angiography with computed tomography using 16 slices (MDCT-16) allows to obtain images of the coronary anatomy due to its high spatial and temporal resolution, and also, to obtain data regarding Left ventricular function. The objective of this study was to correlate the use of MDCT-16 forthe evaluation of the Left ventricular parameters using MRI as the Standard of reference Methods: MRI: Se A 1.5 Tesla GE Cvl Scanner optimized for cardiovascular applications was used. Using an ECG gated steady state fast precession sequence (SSFP, Thickness 10 mm, Flip Angle 45, FOV 36 cm. NEX 1, Frequency 256, Phase 128, Partial FOV 0.75, 16 VPS), 6 to 8 short axis images of from base to apex of the left ventricle were obtained. Tomography: Using a 16 slice Multidetector tomograph (GE Lightspeed) and using ECG synchronization, images of the heart were obtained after the administration of 80 mis. of no-ionic contrast. The images were reconstructed off-line to obtain from 6 to 8 slices in a similar fashion to that of MR. Both studies were independently analyzed by 2 operators who obtained the ventricular function data. Linear correlation and a Paired T Student test was used to analyze the data and was considered significant when p < 0.05. Results: 20 consecutive patients were evaluated with MDCT-16 and MRI, 18 males, mean age 52 ± 15 years. There was no significant difference among the measurements for cardiac CT and MRI of the end-diastolic volume (EDV) and end-sistolic volume (ESV), stroke volume (SV), LV Mass or LV ejection fraction (LVEF). Conclusion: This results show a high correlation among the clinically relevant ventricular function parameters evaluated by cardiovascular CT and MRI. This findings suggest that ventricular function can be successfully evaluated along with the coronary anatomy using MDCT-16.