Single-source dual energy CT to assess myocardial extracellular volume fraction in aortic stenosis before transcatheter aortic valve implantation (TAVI) - 02/09/21
, Jean-Nicolas Dacher a, b, Eric Durand b, c, Jérôme Caudron a, b, Fabrice Bauer b, c, Michael Bubenheim d, Hélène Eltchaninoff b, c, Jean-Michel Serfaty e
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Highlights |
• | Iodine maps using dual energy CT can be used to measure directly myocardial extra cellular volume (ECV). |
• | Myocardial ECV measured by dual-energy CT strongly correlates with MRI measurements. |
• | Myocardial ECV is increased in patients with severe aortic stenosis compared to normal values. |
Abstract |
Purpose |
To assess myocardial extracellular volume fraction (ECV) measurement provided by a single-source dual-energy computed tomography (SSDE-CT) acquisition added at the end of a routine CT examination before transcatether aortic valve implantation (TAVI) compared to cardiac magnetic resonance imaging (MRI).
Materials and methods |
Twenty-one patients (10 men, 11 women; mean age, 86±4.9 years [SD]; age range: 71–92 years) with severe aortic stenosis underwent standard pre-TAVI CT with additional cardiac SSDE-CT acquisition 7minutes after intravenous administration of iodinated contrast material and myocardial MRI including pre- and post-contrast T1-maps. Myocardial ECV and standard deviation (σECV) were calculated in the 16-segments model. ECV provided by SSDE-CT was compared to ECV provided by MRI, which served as the reference. Analyses were performed on a per-segment basis and on a per-patient involving the mean value of the 16-segments.
Results |
ECV was slightly overestimated by SSDE-CT (29.9±4.6 [SD] %; range: 20.9%–48.3%) compared to MRI (29.1±3.9 [SD] %; range: 22.0%–50.7%) (P<0.0001) with a bias and limits of agreement of +2.3% (95%CI: −16.1%–+20.6%) and +2.5% (95%CI: −2.1%–+7.1%) for per-segment and per-patient-analyses, respectively. Good (r=0.81 for per-segment-analysis) to excellent (r=0.97 for per-patient-analysis) linear relationships (both P<0.0001) were obtained. The σECV was significantly higher at SSDE-CT (P<0.0001). Additional radiation dose from CT was 1.89±0.38 (SD) mSv (range: 1.48–2.47 mSv).
Conclusion |
A single additional SSDE-CT acquisition added at the end of a standard pre-TAVI CT protocol can provide ECV measurement with good to excellent linear relationship with MRI.
Le texte complet de cet article est disponible en PDF.Keywords : Computed tomography, Aortic stenosis, Transcatheter aortic valve implantation (TAVI), Magnetic resonance imaging (MRI), Contrast agent
Abbreviations : AHA, ASIR, BMI, CI, CT, CTA, CTDIvol, DE-CT, DLP, DSDE-CT, ECV, FOV, HU, ICA, LGE, MD, MRI, PSIR, ROI, SD, SSDE-CT, TAVI
Plan
Vol 102 - N° 9
P. 561-570 - septembre 2021 Retour au numéro
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