Importance of imaging-acquisition protocol and post-processing analysis for extracellular volume fraction assessment by computed tomography.
J Cardiovasc Comput Tomogr
; 17(3): 222-225, 2023.
Article
en En
| MEDLINE
| ID: mdl-36922309
ABSTRACT
BACKGROUND:
Computed tomography angiography (CTA) assessment of myocardial extracellular volume fraction (CT-ECV) is feasible, although the protocols for imaging acquisition and post-processing methodology have varied. We aimed to identify a pragmatic protocol for CT-ECV assessment encompassing both imaging acquisition and post-processing methodologies to facilitate its clinical implementation.METHODS:
We evaluated consecutive patients with severe aortic stenosis undergoing evaluation for transcatheter aortic valve replacement (TAVR). Pre-contrast and 3-min-delayed CTA were obtained in systole using either helical prospective-ECG-triggered (high-pitch) or axial sequential-ECG-gated acquisition, adding to standard TAVR CTA protocol. Using a dedicated software for co-registration of CTA datasets, three methodologies for ECV measurement were evaluated (1) mid-septum region of interest (Septal ECV), (2) averaged-global ECV (Global ECV) encompassing 16-AHA segments, and (3) average of septal and lateral segments (Averaged ECVsep and Averaged ECVlat).RESULTS:
Among the 142 patients enrolled (median â= â81 years, 44% females), 8 were excluded due to significant imaging artifacts precluding Global ECV assessment. High-pitch scan mode was performed in 68 patients (48%). Suboptimal image quality for Global ECV assessment was associated with high-pitch scan mode (odds ratio OR â= â2.26, p â= â0.036), along with the presence of intracardiac leads (OR â= â4.91, p â= â0.002), and BMI≥35 âkg/m2 (OR â= â2.80, p â= â0.026). Septal ECV [median â= â29.4%] and Averaged ECVsep [29.0%] were similar (p â= â0.108), while Averaged ECVlat [27.5%] was lower than Averaged ECVsep (p â< â0.001), resulting in lower Global ECV [28.6%].CONCLUSIONS:
Myocardial CT-ECV assessment is feasible using a systolic sequential acquisition pre-contrast, and similar additional 3-min delayed scan. Septal ECV measurement provides similar values to Global ECV and is equally reproducible.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Estenosis de la Válvula Aórtica
/
Reemplazo de la Válvula Aórtica Transcatéter
Tipo de estudio:
Guideline
/
Observational_studies
/
Risk_factors_studies
Límite:
Female
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Humans
/
Male
Idioma:
En
Revista:
J Cardiovasc Comput Tomogr
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
RADIOLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos