Comparison of ECG-gated versus non-gated CT ventricular measurements in thirty patients with acute pulmonary embolism.

Autor: Michael Lu, Tianxi Cai, Hale Ersoy, Amanda Whitmore, Noah Levit, Samuel Goldhaber, Frank Rybicki
Zdroj: International Journal of Cardiovascular Imaging; Jan2009, Vol. 25 Issue 1, p101-107, 7p
Abstrakt: Abstract   Objective To prospectively compare cardiac ventricular measurements from non-gated CT and end-diastolic ECG-gated CT in patients with acute pulmonary embolism (PE). Materials and methods With institutional review board approval, 30 adult patients (16 female, mean age = 56 years, range = 26–77 years) underwent ECG-gated cardiac CT within 36 h of their CT diagnosis of acute PE to assess the right ventricle (RV). The axial and reformatted four-chamber ventricular diameters, areas and volumes were measured for both the non-gated CT and the ECG-gated CT in end-diastole and end-systole. Spearman’s rank correlation coefficient (RCC) was calculated to compare measurements from the non-gated CT to the gated end-diastolic measurements. The median absolute differences between the gated and non-gated measurements relative to the gated measurements were provided to summarize the degree to which the two measurements differ. A statistical model was constructed to test for potential improvement in specificity for the prediction of 30-day mortality after acute PE using right ventricular measurements from ECG-gated CT versus non-gated CT. Results The RCC (0.90 confidence interval) for non-gated and ECG-gated end-diastolic four-chamber and axial RV/LV diameter ratios were 0.83 (0.68–0.90) and 0.88 (0.74–0.95). The median absolute percent differences suggested a high degree of concordance between gated and non-gated measurements. The statistical model predicted that measuring the RV/LV diameter ratio from end-diastole using ECG-gated CT rather than non-gated CT would yield a potential improvement in specificity for death after PE of 0.035 (0.020–0.060) for axial diameter ratios and 0.035 (0.020–0.055) for four-chamber diameter ratios. Conclusion The benefit from a separate ECG-gated CT scan for the evaluation of RV ventricular diameter, area, and volume measurements is minimal and does not justify its routine clinical use. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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