Author + information
- Nobusada Funabashi,
- Hiroyuki Takaoka,
- Koya Ozawa,
- Masae Uehara and
- Yoshio Kobayashi
Background: A novel three dimensional (3D) CT strain analysis to evaluate the left ventricular myocardium (LVM) using existing volumetric CT data obtained from retrospective ECG gating acquisition for daily clinical use has become available.
Methods: Eleven consecutive symptomatic patients with non ischemic cardiomyopathy (7 males; 62±17 years, hypertrophic cardiomyopathy 8, peripartum cardiomyopathy 1, drug induced cardiomyopathy 1 and myotonic dystrophy 1) who underwent both cardiac 2nd generation 320- slice CT (Aquilion One/Vision Edition) with retrospective ECG gating acquisition to evaluate coronary arteries and LVM and 1.5 T CMR (Achieva) to evaluate LVM were analyzed retrospectively. The presence of late enhancement (LE), which suggests myocardial fibrosis, was assessed on CMR and CT in all 17 LVM segments (AHA defined). On 3D CT strain analysis, the 3D strain ratio (3DSR) (=segmental 3D strain value per maximum segmental 3D strain value in each case) of each LVM segment was calculated offline using PhyZiodynamics (ziosoft). The best cut-off value of 3DSR for the detection of LE in LVM on CMR was calculated on receiver operating characteristic (ROC) analysis. The presence of LE on CT was assessed segmentally using the following 2 methods: (1) visually confirmed presence of LE in LVM; and (2) visually confirmed presence of LE in LVM with 3DSR < the best cut-off value calculated by ROC analysis.
Results: LE was detected in a total of 46 and 37 segments on CT and CMR, respectively. Using ROC analysis for the detection of LE on CMR, the best cut off value of 3DSR was 0.40 with an area under the curve of 0.74 (P<0.0001), sensitivity 73%, and specificity 70%. Using segment based analysis for the detection of LE on CMR, the sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of visual assessment of LE on CT were 76, 88, 61, 94, and 86%, respectively, in Method 1, and 54, 97, 83, 90, and 89%, respectively, in Method 2. Specificity was significantly higher in Method 2 than in Method 1 (P<0.05).
Conclusions: 3DSR determined by CT has significant incremental value to visual assessment of LE in LVM on CT to detect LE in LVM on CMR in symptomatic patients with non ischemic cardiomyopathy.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: New Technologies
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1292-237
- 2017 American College of Cardiology Foundation