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Evaluation of the Cardiac Chambers on Axial CT: Comparison With Echocardiography

Ramanathan, Rohit MD; Anumandla, Anil K. MD; Haramati, Linda B. MD, MS; Spevack, Daniel M. MD, MS; Godelman, Alla MD; Jain, Vineet R. MD; Kazam, Jacob MD; Burton, William B. PhD; Levsky, Jeffrey M. MD, PhD

Journal of Computer Assisted Tomography: January/February 2014 - Volume 38 - Issue 1 - p 53–60
doi: 10.1097/RCT.0b013e3182a75fbe
Cardiovascular Imaging

Objective To evaluate qualitative and simple quantitative measures of all 4 cardiac chamber sizes on computed tomography (CT) in comparison with transthoracic echocardiography (TTE).

Methods We retrospectively identified 104 adults with electrocardiographically gated cardiac CT and TTE within 3 months. Axial early diastolic (75% R-R) CT images were reviewed for qualitative chamber enlargement, and each chamber was measured linearly. Transthoracic echocardiography was reviewed for linear, area, and volume measurements. Interrater agreement was calculated using Cohen κ and Pearson correlation.

Results There were significant correlations between linear left atrium and left ventricle sizes by CT and TTE (r = 0.686 and r = 0.709, respectively). Correlations for right atrium and right ventricle measurements were lower (r = 0.447 and r = 0.492, respectively). Agreement between CT and TTE for qualitative chamber enlargement was poor (highest κ = 0.35). Computed tomography sensitivity was ≤ 62% for enlargement of all chambers.

Conclusions Linear CT measurements of left-sided chamber sizes correlate well with TTE. Right heart measurements and qualitative assessments agreed poorly with TTE.

From the *Departments of Radiology, †Medicine, Division of Cardiology, ‡Medicine, and §Family and Social Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.

Received for publication June 16, 2013; accepted July 29, 2013.

Reprints: Linda B. Haramati, MD, MS, Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th St, Bronx, NY 10467 (e-mail:

The authors declare no conflict of interest.

Dr. Ramanathan is now with the Department of Radiology, Baylor College of Medicine, Houston, TX.

Dr. Anumandla is now with the Department of Hospital Medicine, Cleveland Clinic, Cleveland, OH.

Dr. Kazam is now with the Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY.

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