- 作者：Sebastian J. Buss ; Felix Schulz ; Derliz Mereles ; Waldemar Hosch ; Christian Galuschky ; Georg Schummers ; Daniel Stapf ; Nina Hofmann ; Evangelos Giannitsis ; Stefan E. Hardt ; Hans-Ulrich Kauczor ; Hugo A. Katus ; Grigorios Korosoglou
- 关键词：2D/3D/4D ; two-dimensional/three-dimensional/four-dimensional ; 2D-CCT ; two-dimensional strain cardiac computed tomography ; 2D-Echo ; two-dimensional strain echocardiography ; CRT ; cardiac resynchronization therapy ; CCT ; cardiac computed tomography ; EF ; ejection fraction ; ESV ; end-systolic volume ; EDV ; end-diastolic volume ; LV ; left ventricle
- 刊名：European Journal of Radiology
- 出版年：March, 2014
- 年：2014
- 卷：83
- 期：3
- 页码：e123-e130
- 全文大小：1452 K
Objectives
To investigate whether cardiac computed tomography (CCT) can determine left ventricular (LV) radial, circumferential and longitudinal myocardial deformation in comparison to two-dimensional echocardiography in patients with congestive heart failure.Background
Echocardiography allows for accurate assessment of strain with high temporal resolution. A reduced strain is associated with a poor prognosis in cardiomyopathies. However, strain imaging is limited in patients with poor echogenic windows, so that, in selected cases, tomographic imaging techniques may be preferable for the evaluation of myocardial deformation.
Methods
Consecutive patients (n = 27) with congestive heart failure who underwent a clinically indicated ECG-gated contrast-enhanced 64-slice dual-source CCT for the evaluation of the cardiac veins prior to cardiac resynchronization therapy (CRT) were included. All patients underwent additional echocardiography. LV radial, circumferential and longitudinal strain and strain rates were analyzed in identical midventricular short axis, 4-, 2- and 3-chamber views for both modalities using the same prototype software algorithm (feature tracking). Time for analysis was assessed for both modalities.
Results
Close correlations were observed for both techniques regarding global strain (r = 0.93, r = 0.87 and r = 0.84 for radial, circumferential and longitudinal strain, respectively, p < 0.001 for all). Similar trends were observed for regional radial, longitudinal and circumferential strain (r = 0.88, r = 0.84 and r = 0.94, respectively, p < 0.001 for all). The number of non-diagnostic myocardial segments was significantly higher with echocardiography than with CCT (9.6% versus 1.9%, p < 0.001). In addition, the required time for complete quantitative strain analysis was significantly shorter for CCT compared to echocardiography (877 卤 119 s per patient versus 1105 卤 258 s per patient, p < 0.001).
Conclusion
Quantitative assessment of LV strain is feasible using CCT. This technique may represent a valuable alternative for the assessment of myocardial deformation in selected patients with poor echogenic windows and general contraindications for magnetic resonance imaging.