Circulation, Vol 82, 202-212, Copyright © 1990 by American Heart Association
ZD Hajduczok, RM Weiss, W Stanford and ML Marcus
There is currently no clinical approach to precisely measure right
ventricular (RV) mass. We postulated that the radiological mode of
ultrafast computed tomography (CT) of 3-mm-thick slices with 0.7-mm
resolution would allow sufficient resolution to accurately estimate RV
mass. Using this radiological mode, we serially imaged the entire right
ventricle from apex to base, gated to end diastole, and applied Simpson's
rule to calculate mass of the RV free wall. Thirteen mongrel dogs (weight,
6-30 kg) were studied. The free wall mass of the right ventricle was in the
range of 12.0-47.5 g and averaged 35.4 +/- 3.7 g (mean +/- SEE). The
correlation between RV mass estimated by ultrafast CT and actual RV mass
was r equaling 0.85, SEE equaling 5.5 g, slope equaling 0.99, and gamma
intercept equaling -1.8. Intraobserver and interobserver variability (r =
0.99 and r = 0.99, respectively) was excellent with a standard deviation
(SD) equal to 1.5 and 1.8, respectively. The effect of variable RV preload
(right atrial pressure, -5 to +20 mm Hg) on accuracy of RV mass
measurements produced minimal error (SD = 3.6 g) in RV mass measurements.
Seven normal young healthy men were also studied. The free wall mass of the
right ventricle was in the range of 48.3-67.4 g and averaged 54.6 +/- 2.8 g
(mean +/- SEE). The left ventricular to right ventricular (LV:RV) ratio
averaged 3.2 +/- 0.2:1. These results are in agreement with human autopsy
data in healthy males reporting mean RV mass equal to 46 g and an LV:RV
ratio equal to 3.4:1. Because imaging every 3-mm slice from apex to base
requires two contrast injections, we determined the accuracy of RV mass
measurements if only every fourth 3-mm slice with interpolation was used.
RV mass measurements using every slice or every fourth slice with
interpolation were excellent (dogs, r = 0.99; humans, r = 0.97). It is
concluded that high resolution CT imaging (3-mm tomograms) allows accurate
measurements of RV mass. It is possible to add this stop- action mode of
ultrafast CT, to previous CT studies, using every fourth tomographic slice
for mass determinations and only one additional contrast injection of 40-60
ml. This should permit the study of progression and regression of RV mass
in patients with various diseases.
ARTICLES
Determination of right ventricular mass in humans and dogs with ultrafast cardiac computed tomography
Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City 52242.
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