Assessment of global left ventricular function and volumes with 320-row multidetector computed tomography: A comparison with 2D-echocardiography

Background: Multidetector computed tomography (MDCT) has been demonstrated as a feasible imaging modality for noninvasive assessment of coronary artery disease and left ventricular (LV) function. Recently, 320-row systems have become available with 16 cm anatomical coverage allowing image acquisition of the entire heart within a single heartbeat. The purpose of this study was to evaluate the accuracy of 320-row MDCT in the assessment of global LV function compared to two-dimensional (2D) echocardiography as the standard of reference. Methods and Results: A head-to-head comparison between 320-row MDCT and 2D-echocardiography was performed in 114 patients (68 men; mean age 62 ± 13 years) who were clinically referred for MDCT coronary angiography. The entire heart was imaged in a single heartbeat, using prospective dose modulation. LV end-diastolic volumes (LVEDV) and LV endsystolic volumes (LVESV) were determined and the LV ejection fraction (LVEF) was derived. Average LVEF was 60 ± 10% (range 26-78%) as determined on MDCT, compared with 59 ± 10% (range 25-77%) on 2D-echocardiography. Evaluation of LVEF by linear regression analysis showed a good correlation between MDCT and 2D-echocardiography (r² = .87; P < .001). Good correlations between MDCT and 2D-echocardiography were demonstrated for the assessment of LVEDV (r² = .91; P < .001) and LVESV (r² = .94; P < .001). At Bland-Altman analysis, mean differences (±SD) of 7.3 ± 12.1 mL (P < .05) and 1.8 ± 7.4 mL (P < .05) were observed between MDCT and 2D-echocardiography for LVEDV and LVESV, respectively. LVEF was slightly overestimated with MDCT (.9 ± 3.6%; P < .05). Conclusions: Accurate assessment of LV function and volumes is feasible with single heartbeat 320-row MDCT in patients referred for MDCT coronary angiography.