Quantitative assessment of right ventricular function and pulmonary regurgitation in surgically repaired tetralogy of Fallot using 256-slice CT: comparison with 3-Tesla MRI

Yuzo Yamasaki, Michinobu Nagao, Kenichiro Yamamura, Masato Yonezawa, Yoshio Matsuo, Satoshi Kawanami, Takeshi Kamitani, Ko Higuchi, Ichiro Sakamoto, Yuichi Shiokawa, Hidetake Yabuuchi, Hiroshi Honda

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Objectives: To compare 256-slice cardiac computed tomography (CCT) with cardiac magnetic resonance (CMR) imaging to assess right ventricular (RV) function and pulmonary regurgitant fraction (PRF) in patients with repaired tetralogy of Fallot (TOF).

Methods: Thirty-three consecutive patients with repaired TOF underwent retrospective ECG-gated CCT and 3-Tesla CMR. RV and left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) were measured using CCT and CMR. PRF-CCT (%) was defined as (RVSV − LVSV)/RVSV. PRF-CMR (%) was measured by the phase-contrast method. Repeated measurements were performed to determine intra- and interobserver variability.

Results: CCT measurements, including PRF, correlated highly with the CMR reference (r = 0.71–0.96). CCT overestimated RVEDV (mean difference, 17.1 ± 2.9 ml), RVESV (12.9 ± 2.1 ml) and RVSV (4.2 ± 2.0 ml), and underestimated RVEF (−2.6 ± 1.0 %) and PRF (−9.1 ± 2.0 %) compared with CMR. The limits of agreement between CCT and CMR were in a good range for all measurements. The variability in CCT measurements was lower than those in CMR. The estimated effective radiation dose was 7.6 ± 2.6 mSv.

Conclusions: 256-slice CCT can assess RV function and PRF with relatively low dose radiation exposure in patients with repaired TOF, but overestimates RV volume and underestimates PRF.

Key points: • 256-slice CT assessment of RV function is highly reproducible in repaired TOF.

• Pulmonary regurgitation can be evaluated by biventricular systolic volume difference.

• CT overestimates RV volume and underestimates pulmonary regurgitation, compared with MRI.

Original languageEnglish
Pages (from-to)3289-3299
Number of pages11
JournalEuropean Radiology
Issue number12
Publication statusPublished - Nov 14 2014


All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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