Report from ECR 2008: 64-slice CT shows value for the assessment of the right heart

The enhanced spatial resolution and speed afforded by 64-slice CT scanning could enable the accurate assessment of right ventricular function in patients with cardiovascular disease, according to researchers in China and the U.S.

Anatomic and functional analysis of the right ventricle could add valuable information to the diagnosis of cardiopulmonary diseases and may also improve risk stratification, prognosis, and patient management. But imagers say that measuring right ventricular function accurately has always been challenging. The high spatial and temporal resolution of 64-slice CT scanners now makes this possible, said Dr. Ying-kun Guo, a radiologist at the West China Hospital in Chengdu and principal investigator of a prospective study of mitral regurgitation patients.

Guo and colleagues assessed right ventricular function and size in 48 consecutive patients with mitral regurgitation who underwent ECG-gated 64-slice CT. Patients also underwent 3D echocardiography and cardiac MR imaging, which were used for comparison.

The investigators found that 64-slice CT provided accurate assessment of right ventricular function and volume and matched measurements from 3D echocardiography and MRI. They released findings Saturday at the 2008 ECR meeting.

Researchers found no significant differences in right ventricular volume, ejection fraction, and right/left ventricular size assessments provided by all three modalities. They also observed a closer correlation between CT- and echocardiography-based analyses of mitral regurgitation. Sixty-four-slice CT measurements, however, showed the lowest variability.

On another study, an investigative team led by Dr. Heon Lee from the Medical University of South Carolina in Charleston sought to obtain information on right ventricle function during contrast-enhanced coronary CT angiography.

Lee and colleagues enrolled 40 patients without signals of valvular insufficiency on echocardiography who underwent contrast-enhanced CTA on a 64-slice device. The investigators found the degree of contrast attenuation during coronary CTA influenced right ventricle functional analysis. The correlation between ventricular function and contrast attenuation in the inferior right ventricle was statistically significant (p

"For RV function to be clinically important there should be at least intermediate contrast attenuation in the inferior RV," Lee said.