Diagnostic Accuracy of Sex-Specific Chest CT Measurements Compared With Cardiac MRI Findings in the Assessment of Cardiac Chamber Enlargement.

Abstract

The purpose of this study was to establish sex-specific chest CT measurement thresholds for detection of cardiac chamber enlargement with cardiac MRI as the reference standard. Consecutive patients who underwent contrast-enhanced chest CT (64- or 320-MDCT) and cardiac MRI within a 7-day interval between August 2006 and August 2016 were included in this retrospective study (n = 217; 115 men, 102 women; mean age, 52.8 ± 15.8 years). Measurements were performed on axial CT images to evaluate right atrial (RA), right ventricular (RV), left atrial (LA), and left ventricular (LV) chamber size. The presence of chamber enlargement (RAE, RVE, LAE, and LVE) was established with cardiac MRI as the reference standard. ROC analysis was performed. Optimal sex-specific CT measurement thresholds were identified that ensured specificity of 90% or greater and maximized sensitivity. The prevalence of chamber enlargement in men was 26% for RAE, 11% for RVE, 40% for LAE, and 24% for LVE. In women the prevalence was 16% for RAE, 15% for RVE, 27% for LAE, and 12% for LVE. The following CT measurement thresholds were optimal: for RAE, RA transverse diameter ≥ 67 mm for men (AUC, 0.825) and ≥ 64 mm for women (AUC, 0.926); for RVE, RV transverse diameter ≥ 60 mm for men (AUC, 0.846) and ≥ 57 mm for women (AUC, 0.858); for LAE, LA anteroposterior diameter ≥ 50 mm for men (AUC, 0.795) and ≥ 45 mm for women (AUC, 0.841); for LVE, LV transverse diameter ≥ 58 mm for men (AUC, 0.917) and ≥ 53 mm for women (AUC, 0.840). Cardiac chamber enlargement can be identified with high specificity and reasonable sensitivity on axial chest CT images by use of sex-specific measurement thresholds.