Abstract 17849: Echocardiography Underestimates Right Heart Size in Patients With Atrial Septal Defect: Evidence From Fusion Imaging With Multidetector Computed Tomography
Background: Quantification of right heart size is essential for risk assessment in patients with atrial septal defect (ASD), although accurate measurement of right heart size in a single 2-dimensional echocardiographic view is difficult due to its unique structure. Recently, an innovative imaging technique has been developed to display in real time a virtual multi-planar reconstruction obtained from contrast-enhanced multidetector-computed tomography (MD-CT) volume data corresponding to the same cross-sectional image from echocardiography (Smart Fusion, Toshiba).
Methods: We studied 27 patients with secundum ASD. All patients underwent echocardiography within a week of contrast-enhanced MD-CT. After importing MD-CT dataset to echo machine, both MD-CT and echocardiographic images were displayed simultaneously in the same screen. Next, two referable markers were set at the same position anatomically in each image, and then MD-CT images act in synchronization with echocardiography (Figure). We measured left ventricular, left atrial, right ventricular and right atrial areas and maximal defect diameter in both images.
Results: Left ventricular area, left atrial area, and defect diameter showed significant correlations between MD-CT and echocardiography (r = 0.96, 0.97, and 0.92, respectively, all p < 0.05) and showed no significant differences between the two (all p = ns). Right ventricular area and right atrial area (right ventricular area: MDCT 28 ± 10 vs. echocardiography 24 ± 9 cm2; right atrial area: 26 ± 9 vs. 23 ± 8 cm2) showed significant correlations between the two (r = 0.95 and 0.90, respectively, both p < 0.05), although the values from MD-CT were higher than those from echocardiography (both p < 0.01).
Conclusions: Fusion imaging with MD-CT reveals that echocardiography provides accurate measurements of left heart and defect size, whereas it underestimates right heart size in patients with ASD.
- © 2013 by American Heart Association, Inc.