Multisegment and halfscan reconstruction of 16-slice computed tomography for assessment of regional and global left ventricular myocardial function.
ABSTRACT We sought to prospectively compare multisegment and halfscan reconstruction of 16-slice computed tomography (CT) for the assessment of regional and global left ventricular myocardial function with magnetic resonance imaging (MRI) as the reference standard.
Forty-two patients underwent CT with 16 x 0.5-mm detector collimation. Electrocardiogram-gated reconstructions were generated with multisegment reconstruction (using up to 4 segments correlated with the raw data of up to 4 heartbeats) and standard halfscan reconstruction. Steady-state free-precession cine MRI was acquired within 24 hours.
More normal myocardial segments were identified correctly with multisegment (95%, 620/656) compared with halfscan reconstruction (88%, 582/656) of CT (P < 0.001). Also, the accuracy (92% [657/714] vs. 87% [620/714]) and rate of nondiagnostic segments (0% vs. 5% [33/714]) were significantly better when using multisegment reconstruction (P < 0.001). The image quality with multisegment reconstruction was significantly superior to that achieved with halfscan reconstruction (P < 0.001). In the assessment of global left ventricular function, multisegment and halfscan reconstruction of CT showed high correlations for all parameters with MRI, whereas Bland-Altman analysis revealed smaller limits of agreement for assessment of myocardial mass with multisegment reconstruction (P = 0.025), but no significant differences between both reconstruction techniques in the measurement of left ventricular volumes as compared with MRI.
Multisegment reconstruction of 16-detector row CT improves image quality and assessment of regional wall motion compared with standard halfscan reconstruction.
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ABSTRACT: Noninvasive angiography using multislice computed tomography (MSCT) is superior to magnetic resonance imaging (MRI) for detection of coronary stenoses. We compared patient acceptance of these two noninvasive diagnostic tests and invasive conventional coronary angiography (Angio). A total of 111 consecutive patients with suspected coronary artery disease underwent MSCT, MRI, and Angio. Subsequently, patient acceptance of the three tests was evaluated with questionnaires in all patients. The main acceptance variables were preparation and information prior to the test, degree of concern, comfort, degree of helplessness, pain (on visual analog scales), willingness to undergo the test again, and overall satisfaction. Preparation for each test was not rated significantly differently, whereas patients were significantly more concerned about Angio than the two noninvasive tests (p<0.001). No pain during MSCT, MRI, and Angio as assessed on visual analog scales (0 to 100) was reported by 99, 93, and 31 patients, respectively. Among the 82 patients who felt pain during at least one procedure, both CT (0.9+/-4.5) and MRI (5.2+/-16.6) were significantly less painful than Angio (24.6+/-23.4, both p<0.001). MSCT was considered significantly more comfortable (1.49+/-0.64) than MRI (1.75+/-0.81, p<0.001). In both the no-revascularization (55 patients) and the revascularization group (56 patients), the majority of the patients (73 and 71%) would prefer MSCT to MRI and Angio for future imaging of the coronary arteries. None of the patients indicated to be unwilling to undergo MSCT again. The major advantages patients attributed to MSCT were its fast, uncomplicated, noninvasive, and painless nature. Noninvasive coronary angiography with MSCT is considered more comfortable than MRI and both MSCT and MRI are less painful than Angio. Patient preference for MSCT might tip the scales in favor of this test provided that the diagnostic accuracy of MSCT can be shown to be high enough for clinical application.PLoS ONE 01/2007; 2(2):e246. · 4.09 Impact Factor