Cardiac Functional Analysis를 위한 ECG-gated MDCT의 유용성과 MRI, SPECT, Echocardiography와의 비교분석

The Usefulness of ECG-gated MDCT for The Cardiac Functional Analysis; and Comparison with MRI, SPECT, Echocardiography

Purpose In the evaluation of ischemic heart disease, accurate measurement of cardiac function is very important as well as the evaluation of vessel status of coronary artery. therefore we evaluate the accuracy of cardiac functional analysis using ECG-gated MDCT compare with other imaging modality such as MRI, single photon emission computed tomography and echocardiography. Materials and Methods We recruited 21 patients(age range:51~78, mean age:62.8±10.69, sex: male-13 female-8) with ischemic heart disease that underwent 4 exam(CT, MRI, single photon emission computed tomography and Echo) all within 1 month. We used 16 slice MDCT(Mx8000 IDT, Philips Medical Systems, Netherland) and dual injector(Medrad, USA). We measured 4 cardiac functional data(ejection- fraction %, end-diastolic volume, end-systolic volume and mass) of left ventricle. To measure data, we used end-systolic & end-diastolic reconstruction phase during cardiac cycle in ECG-gated cardiac CT. 4 cardiac functional data(EF, EDV, ESV and mass) were measured at short axis view using semiautomated contour technique in Extended Brilliance workstation(Brilliance version 2.0, Philips Medical Systems). This cardiac functional data obtained from CT was compared with MRI, ECG-gated single photon emission computed tomography, echocadiography. MRI is known to reference standard of cardiac function. therefore we analyzed the accuracy of cardiac functional data each modality(CT, single photon emission computed tomography, echocadiography) compared with MRIcardiac functional data as reference of standard. Results We analyze difference MRI with other modality(CT, single photon emission computed tomography, echocardiography). First, mean difference for the measurement of EF(%) is CT ±2.7, SPECT ±6.7, echocardiography: ±7.01. Second, end-diastolic volume(EDV) value(ml), mean of difference is CT: ±18.3, SPECT ±44.1 except echocardiography(because echocardiography is not volume but two dimentional diameter). Third, end-systolic volume(ESV) value(ml), mean of difference is CT: ±8.57, SPECT ±15.9 also except echocardiography. At last, left ventricle mass score is only compare MRI with CT and not include papillary muscle. Mean of difference is CT: ±8.09. Conclusion From thisstudy, we concluded that ECG-gated MDCT is more accurate than SPECT or echocardiography for the assessment of cardiac function. According to MDCT is rapidly developed like as 64 MDCT, improvement of temporal resolution bring to reduce artifact that is influenced heart rate. Therefore MDCT will play an important role in the near future for the evaluation of cardiac functional analysis.