Abstract
To perform a head-to-head comparison between magnetic resonance imaging (MRI) and
gated single-photon emission computed tomography (SPECT) for the evaluation of left
ventricular (LV) function (LV ejection fraction [LVEF], LV volumes, and regional wall
motion) in patients with ischemic cardiomyopathy, we studied 22 patients with chronic
coronary artery disease and LV dysfunction. Multislice, multiphase echoplanar MRI
was performed with Philips Gyroscan ACS-NT15. Image analysis was performed using the
MASS software package to determine LV end-systolic volume, LV end-diastolic volume,
and LVEF. The same parameters were calculated using quantitative gated SPECT software
(QGS, Cedars-Sinai Medical Center). The different parameters were compared using linear
regression, and correlation coefficients were calculated. Regional wall motion was
also determined from both techniques, according to a 13-segment model and a 3-point
scoring system (from 1 = normokinesia to 3 = akinesia or dyskinesia). A summed wall
motion score was also calculated for MRI and gated SPECT. Good correlations were found
between MRI and gated SPECT for all parameters: (1) summed wall motion scoreMRI versus summed wall motion scoreSPECT: y = 0.74x + 8.0, r = 0.88, p <0.01; (2) LV end-systolic volumeMRI versus LV end-systolic volumeSPECT: y = 0.94x − 12.3, r = 0.87, p <0.01; (3) LV end-diastolic volumeMRI versus LV end-diastolic volumeSPECT: y = 0.93x − 18.4, r = 0.84, p <0.01; and (4) LVEFMRI versus LVEFSPECT: y = 0.97x + 0.68, r = 0.90, p <0.01. For regional wall motion, an exact agreement
of 83% was found, with a kappa statistic of 0.77 (95% confidence intervals 0.71 to
0.83, SE 0.03), indicating essentially excellent agreement. Thus, close and significant
correlations were observed for assessment of LVEF, LV volumes, and regional wall motion
by MRI and gated SPECT in patients with ischemic cardiomyopathy.
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References
- Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction.Circulation. 1987; 76: 44-51
- Comparative accuracy of apical biplane cross-sectional echocardiography and gated equilibrium radionuclide angiography for estimating left ventricular size and performance.Circulation. 1981; 63: 1075-1084
- Magnetic resonance imaging in coronary artery disease.Circulation. 1995; 92: 2723-2739
- Multiple gated cardiac blood pool imaging for left ventricular ejection fraction.Am J Cardiol. 1979; 43: 1159-1165
- 201Tl and 99mTc-MIBI gated SPECT in patients with large perfusion defects and left ventricular dysfunction.J Nucl Med. 1999; 40: 805-809
- Quantitative LVEF and qualitative regional function from gated thallium-201 perfusion SPECT.J Nucl Med. 1997; 38: 749-754
- Automatic quantification of ejection fraction from gated myocardial perfusion SPECT.J Nucl Med. 1995; 36: 2138-2147
- Identification of severe and extensive coronary artery disease by automatic measurement of transient ischemic dilation of the left ventricle in dual-isotope myocardial perfusion SPECT.J Am Coll Cardiol. 1996; 27: 1612-1620
- Postischemic stunning can affect left ventricular ejection fraction and regional wall motion on post-stress gated sestamibi tomograms.J Am Coll Cardiol. 1997; 30: 1641-1648
- Evaluation of left ventricular wall motion, volumes, and ejection fraction by gated myocardial tomography with Tc-99m tetrofosmin.J Nucl Cardiol. 1998; 6: 3-10
- Validation of left ventricular volume measurements by gated SPECT 99mTc-labeled sestamibi imaging.J Nucl Cardiol. 1998; 5: 574-578
- Validation of global and segmental left ventricular contractile function using gated planar technetium-99m sestamibi myocardial perfusion imaging.J Am Coll Cardiol. 1994; 23: 141-145
- Regional myocardial wall thickening and global ejection fraction in patients with low angiographic left ventricular ejection fraction assessed by visual and quantitative resting ECG-gated 99mTc-tetrofosmin single-photon emission tomography and magnetic resonance imaging.Eur J Nucl Med. 1998; 25: 522-530
- Gated technetium-99m-tetrofosmin SPECT and cine MRI to assess left ventricular contraction.J Nucl Med. 1997; 38: 438-442
- Automatic quantitation of regional myocardial wall motion and thickening from gated technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography.J Am Coll Cardiol. 1997; 30: 1360-1367
- Regional myocardial motion and thickening assessed at rest by ECG-gated 99mTc-MIBI emission tomography and by magnetic resonance imaging.Eur J Nucl Med. 1996; 23: 909-916
- Left ventricular function in patients with coronary artery disease assessed by gated tomographic myocardial perfusion images. Comparison with assessment by contrast ventriculography and first-pass radionuclide angiography.J Am Coll Cardiol. 1996; 27: 173-181
- Echo planar MRI of the heart on a standard system.J Comput Assist Tomogr. 1996; 20: 942-949
- Automated detection of left ventricular epi- and endocardial contours in short-axis MR images.Comput Cardiol. 1997; 21: 33-36
- Left ventricular measurements with cine and spin-echo MR imaging; a study of reproducibility with variance component analysis.Radiology. 1993; 187: 261-268
- Statistical Methods for Rates and Proportions. 2nd ed. Wiley, New York, NY1981
- Statistical methods for assessing agreement between two methods of clinical assessment.Lancet. 1986; 1: 307-310
- Repeatability of automatic left ventricular cavity volume measurements from myocardial perfusion SPECT.J Nucl Cardiol. 1998; 5: 477-483
Article Info
Publication History
Accepted:
June 21,
2000
Received in revised form:
June 21,
2000
Received:
April 3,
2000
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
