Quantitative and qualitative assessment of left ventricular volume with ECG-gated multislice spiral CT:: Value of different image reconstruction algorithms in comparison to MRI

Purpose: To assess the value of different image reconstruction algorithms for assessment of the left ventricular function using retrospectively ECG-gated multislice spiral computed tomography (MSCT) of the heart. Material and Methods: MSCT and cine magnetic resonance (MR) imaging of the heart were performed in 15 patients. For MSCT, standard and multisegmental image reconstruction with improved temporal resolution were used. Standardized multiplanar reformats in the short axis and long axis views were reconstructed from MSCT data. End-systolic (ESV) and end-diastolic volume (EDV), stroke volume (SV), ejection fraction (EF) and myocardial mass (MM) were calculated. Left ventricular wall motion was assessed qualitatively. Results: MSCT was in acceptable agreement with MR imaging for quantification of the ventricular function. According to the Bland-Altman approach the mean differences for the left ventricular volumes (ESV, EDV, SV) ranged from -9.6 ml to 3.1 ml with standard image reconstruction and from -0.6 ml to 1.9 ml utilizing multisegmental image reconstruction with limits of agreement ranging from -26.6 ml to 12.5 ml and -15.6 ml to 15.0 ml, respectively. Applying the multisegmental image reconstruction algorithm, a significantly improved agreement with the MR data was found for EDV, SV and EF. For wall motion analysis, standard image reconstruction showed a significant difference to MR imaging with a correspondence in 83.75% of the 240 assessed segments, while multisegmental image reconstruction agreed with MR imaging in 92.5% of the segments. Conclusion: Multisegmental image reconstruction improves the quantitative assessment of left ventricular function when compared to standard image reconstruction. Multisegmental image reconstruction allows qualitative wall motion analysis.