Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Estimation of Diastolic Filling Pressure with Cardiac CT in Comparison with Echocardiography Using Tissue Doppler Imaging: Determination of Optimal CT Reconstruction Parameters

  • Hwang, Ji-Sun (Department of Radiology, Soonchunhyang University Hospital Bucheon) ;
  • Lee, Heon (Department of Radiology, Soonchunhyang University Hospital Bucheon) ;
  • Lee, Bora (Department of Biostatistics, Soonchunhyang University College of Medicine) ;
  • Lee, Soo-Jeong (Terarecon Korea) ;
  • Jou, Sung Shick (Department of Radiology, Soonchunhyang University Hospital Cheonan) ;
  • Lim, Hyun Kyung (Department of Radiology, Soonchunhyang University Hospital Seoul) ;
  • Suh, Jon (Department of Cardiology, Soonchunhyang University Hospital Bucheon)
  • Received : 2016.07.29
  • Accepted : 2016.10.30
  • Published : 2017.08.01
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Abstract

Objective: To determine the optimal CT image reconstruction parameters for the measurement of early transmitral peak velocity (E), early peak mitral septal tissue velocity (E'), and E / E'. Materials and Methods: Forty-six patients underwent simultaneous cardiac CT and echocardiography on the same day. Four CT datasets were reconstructed with a slice thickness/interval of 0.9/0.9 mm or 3/3 mm at 10 (10% RR-interval) or 20 (5% RR-interval) RR-intervals. The E was calculated by dividing the peak transmitral flow (mL/s) by the corresponding mitral valve area ($cm^2$). E' was calculated from the changes in the left ventricular length per cardiac phase. E / E' was then estimated and compared with that from echocardiography. Results: For assessment of E / E', CT and echocardiography were more strongly correlated (p < 0.05) with a slice thickness of 0.9 mm and 5% RR-interval (r = 0.77) than with 3 mm or 10% RR-interval. The diagnostic accuracy of predicting elevated filling pressure ($E/E^{\prime}{\geq}13$, n = 14) was better with a slice thickness of 0.9 mm and 5% RR-interval (87.0%) than with 0.9 mm and 10% RR-interval (71.7%) (p = 0.123) and significantly higher than that with a slice thickness of 3 mm with 5% (67.4%) and 10% RR-interval (63.0%), (p < 0.05), respectively. Conclusion: Data reconstruction with a slice thickness of 0.9 mm at 5% RR-interval is superior to that with a slice thickness of 3 mm or 10% RR-interval in terms of the correlation of E / E' between CT and echocardiography. Thin slices and frequent sampling also allow for more accurate prediction of elevated filling pressure.

Keywords

Acknowledgement

Supported by : Soonchunhyang University

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