Cardiovasc Imaging Asia.  2019 Jul;3(3):61-67. 10.22468/cvia.2019.00052.

Volumetric Severity Assessment of Ebstein Anomaly Using Three-Dimensional Cardiac CT: A Feasibility Study

Affiliations
  • 1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ghw68@hanmail.net

Abstract


OBJECTIVE
The purpose of this study was to demonstrate the feasibility of using cardiac CT to perform volumetric severity assessment of the Ebstein anomaly.
MATERIALS AND METHODS
Six children with Ebstein anomaly were included. We used cardiac CT to measure the delineated tricuspid valve, streak artifacts, and contrast enhancement heterogeneity. Cardiac CT data were used to quantify the volumes of all of the cardiac chambers, including the atrial and functional right ventricle (RV). In addition, the functional RV (fRV) fraction, fRV/left ventricle (LV) volume ratio, and total right/left-volume index were calculated. The volume-based CT severity index was compared using area-based echocardiographic and CT severity indices.
RESULTS
All of the patients had grade 3 or 4 extent of delineation of the malformed tricuspid valve and streak artifacts. In one case, the right atrium had image noise [126.7 Hounsfield units (HU)] that was >50 HU, while all others demonstrated image noise <50 HU. This image quality was appropriate to make all of the volumetric measurements. The RV volumes were enlarged in 83.3% (5/6) of the cases. The fRV fraction was 60.8-61.5%. The fRV/LV volume ratio and total right/left-volume index were 2.0±1.4 and 3.5±1.5, respectively. There was a smaller difference (0.2±0.1) between the area-based and volume-based CT severity indices than there was in other comparisons. These parameters also had a higher concordance rate (83.3%, 5/6) in the severity grades.
CONCLUSION
Volumetric severity assessment using cardiac CT is feasible in Ebstein anomaly, and may be useful to characterize the disease's diverse phenotypes.

Keyword

Cardiac imaging technique; Ebstein anomaly; Multidetector computed tomography; Severity of illness index; Imaging, three-dimensional; Ventricular function

MeSH Terms

Artifacts
Cardiac Imaging Techniques
Child
Ebstein Anomaly*
Echocardiography
Feasibility Studies*
Heart Atria
Heart Ventricles
Humans
Imaging, Three-Dimensional
Multidetector Computed Tomography
Noise
Phenotype
Population Characteristics
Severity of Illness Index
Tricuspid Valve
Ventricular Function
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