Simple area-based measurement for multidetector computed tomography to predict left ventricular size

Abstract

Objective-Measures of left ventricular (LV) mass and dimensions are independent predictors of morbidity and mortality. We determined whether an axial area-based method by computed tomography (CT) provides an accurate estimate of LV mass and volume.Method-45 subjects (49% female, 56.0±12 years) with a wide range of LV geometry underwent contrast-enhanced 64-slice CT. LV mass and volume were derived from a 3D data set. 2D images were analysed to determine LV area as well the direct transverse cardiac diameter (dTCD) and the cardiothoracic ratio (CTR). Further, feasibility was confirmed in 100 Framingham Offspring Cohort subjects.Results-2D measures of LV area, dTCD and CTR were 47.3±8 cm 2 , 14.7±1.5 cm and 0.54±0.05, respectively. 3D-derived LV volume (end-diastolic) and mass were 148.9±45 cm 3 and 124.2±34 g, respectively. Excellent inter-and intra-observer agreement were shown for 2D LV area measurements (both ICC=0.99, p<0.0001) and could be confirmed on non-contrast CT. The measured 2D LV area was highly correlated to LV volume, mass, and size (r=0.68; r=0.73; r=0.82; all p<0.0001; respectively). On the other hand, CTR was not correlated to LV volume, mass, size or 2D LV area (all p>0.27).Conclusion-Compared with traditionally used CTR, LV size can be accurately predicted based on a simple and highly reproducible axial LV area-based measurement.

Cardiothoracic ratio in postmortem computed tomography: reliability and threshold for the diagnosis of cardiomegaly

“…The high inter-reader reliability for the CTR in this study suggests that linear measurements on axial CT scans are a simple and effective means of assessing cardiomegaly postmortem. This stands in agreement with the technical approach of other studies and supports the use of this method for quantifying the diameter of the thorax and heart on CT images [10][11][12].…”

“…In both cases, linear measurements were taken in an adapted way according to the method of Ungerleider and Gubner [6] as described in several previous CT studies [10][11][12]. All measurements were performed on axial slices using the workstation caliper tool.…”

“…Several studies have assessed and adapted the CTR approach to computed tomography (CT) and these measures have been shown to correlate highly with those from CXR [10][11][12]. Despite this, there continue to be differing opinions regarding the clinical reliability and usefulness of the CTR in cross sectional imaging [10][11][12].…”

Relation of Thoracic Aortic Distensibility to Left Ventricular Area (from the Multi-Ethnic Study of Atherosclerosis [MESA])

“…7–11 Recently, LV area has been shown to be an accurate and highly reproducible surrogate of LV mass and volumes. 12, 13 It is easily obtained from gated chest computed tomography (CT). While the correlation between LV mass and aortic distensibility (AD) has been well demonstrated, the correlation between LV area on CT and AD has not been studied.…”

The cardiothoracic ratio—an inaccurate and outdated measurement: new data from CT

“…In this issue of European Radiology, Schlett et al [1] elegantly describe simple methods for assessment of left ventricular (LV) size based on single level area and transverse diameter measurements using readily recognisable anatomical landmarks on transverse CT and projection digitally acquired radiographs (CT scout images). This evaluation can be performed on both unenhanced and contrast medium-enhanced examinations, is reproducible, practical (taking 1 min to perform) and correlates closely with three-dimensional assessment of LV volume, muscle mass and size.…”