Left Ventricular Global Function Analysis by Multi-Detector CT Threshold Based Three Dimension Segmentation Method in Patients with Coronary Artery Disease: A Comparative Study with Two Dimensional Echocardiography

Abstract
Background: Evaluation of global left ventricular function in patients with Coronary Artery Disease (CAD) is important for clinical diagnosis, risk assessment, therapeutic decisions, and prognosis. Because MDCT is a noninvasive imaging modality frequently used for the assessment of coronary artery disease, its ability to assess the LV volumes and EF has to be evaluated and compared with Two Dimensional Standard Echocardiography (2DSE).
Aim of Work: To evaluate the role of MDCT threshold based segmentation method in quantification of global left ventricular function in patients with coronary artery disease and compare MDCT data with 2D-echocardiography as the standard of reference.
Patients and Methods: Sixty patients with suspected coronary artery disease underwent contrast enhanced MDCT using retrospective gating. Ten phases of cardiac cycle were processed to assess end-systolic and end-diastolic phase at LV short-axis view. 2DSE was performed within two weeks before MDCT. Left Ventricular Ejection Fraction (LVEF), Left Ventricular End-Diastolic Volume (LVDV) and Left Ventricular End-Systolic Volume (LVSV) were calculated using the three dimensional threshold based segmentation method (in MDCT) and modified Simpson method (in echocar-diography).
Results: LVEF, LVDV and LVSV were 51.9±10.9, 182.5± 45.2 and 89.8±40.2 and 51.6±10.5, 175.4±32.3 and 87.2±30.6 on MDCT and echocardiography respectively with excellent correlation between the two modalities (p;0.001) using Pear-son's correlationcoefficient. A Bland-Altman analysis showed that MDCT had slightly higher LVEF, LVDV and LVSV values with mean value of differences of 0.6%, 7ml and 2.5ml respectively, MDCT segmentation method had an accuracy of 91.6%, 95% and 98.3% respectively.
Conclusion: MDCT threshold based 3D segmentation method is an accurate method for quantitative evaluation of global left ventricular function compared to 2D echocardiog-raphy.