PubMed Health⌕ Search

Biomedical subjects

Albert de Roos

Publications and source records attributed to Albert de Roos.

At least 37 records · Page 2Linked to original sources
PubMed2006

Do risk factors influence the diagnostic accuracy of noninvasive coronary angiography with multislice computed tomography?

BACKGROUND: Multislice computed tomography (MSCT) is a relatively new noninvasive imaging modality in the evaluation of patients with suspected coronary artery disease (CAD). Whether diagnostic accuracy is influenced by gender or risk factors for CAD is currently unknown and was evaluated in this study. METHODS AND RESULTS: In 197 patients (171 men and 26 women; mean age, 60 +/- 11 years) 16-slice MSCT was performed and compared with invasive coronary angiography at 2 different centers (Leiden and Rotterdam, The Netherlands). Diagnostic accuracy for the detection of 50% luminal narrowing or greater was calculated for all patients combined, as well as for patients with known versus suspected CAD. In addition, diagnostic accuracy was determined in men versus women and in different subsets of patients based on the presence of risk factors for CAD including hypertension, type 2 diabetes mellitus, hypercholesterolemia, and obesity. Only segments with a diameter of 2.0 mm or greater were evaluated, whereas smaller segments and stents were excluded from the analysis. Overall, a sensitivity and specificity of 99% and 86%, respectively, on a patient level were demonstrated, with corresponding positive and negative predictive values of 95% and 96%, respectively. Similar values were observed in the different subsets of patients, with no statistical differences. CONCLUSION: These findings confirm the high diagnostic accuracy of MSCT, regardless of gender or risk factors.

Aged↗
PubMed2006

Advances in the noninvasive evaluation of coronary artery disease with multislice computed tomography.

Current noninvasive detection of coronary artery disease (CAD) is based on the demonstration of ischemia using stress-rest imaging, which is an indirect way of identifying CAD by demonstration of the hemodynamic consequences, rather than direct visualization of the obstructive lesions in the coronary arteries. Multislice computed tomography (MSCT) has recently emerged as an extremely rapidly developing noninvasive imaging modality, which allows anatomical imaging of the coronary arteries or noninvasive coronary angiography. In addition, total plaque burden, plaque morphology and (to some extent) plaque constitution can be assessed by MSCT. The technique also provides information on resting left ventricular systolic function, and possibly resting perfusion. Ideally, stress function and perfusion should also be evaluated, since this would allow detection of ischemia and would complete the picture of CAD. However, this is not routinely performed, since sequential acquisitions are associated with high radiation doses and thus pose a limitation for cardiovascular applications of MSCT. It is anticipated that, with a reduction in radiation, MSCT may become an important player in the diagnostic and prognostic work-up of patients with known or suspected CAD.

Coronary Angiography↗
PubMed2006

MDCT assessment of right ventricular systolic function.

OBJECTIVE: The objective of our study was to validate using MDCT for the assessment of right ventricular (RV) function. MDCT with retrospective ECG gating was performed in 15 patients being evaluated for suspected cardiovascular disease. Echocardiography was performed for comparison. The MDCT images were reconstructed at 20 phase points over the cardiac cycle. The end-diastolic and end-systolic volumes of both ventricles were measured. Stroke volumes and ejection fractions were calculated from these data. CONCLUSION: RV volumes can be accurately assessed using MDCT.

Electrocardiography↗
PubMed2006

A comparative regional analysis of coronary atherosclerosis and calcium score on multislice CT versus myocardial perfusion on SPECT.

UNLABELLED: For the noninvasive evaluation of coronary artery disease (CAD), both multislice CT and gated SPECT are available. How these 2 modalities relate, however, is yet unclear. The purpose of this study was to perform a head-to-head comparison of the results of multislice CT and gated SPECT on a regional basis (per vessel distribution territory) in patients with known or suspected CAD. METHODS: One hundred forty patients underwent both multislice CT for coronary calcium scoring and coronary angiography and gated SPECT for myocardial perfusion imaging. The coronary calcium score was determined for each coronary artery. Coronary arteries on multislice CT angiography were classified as having no CAD, insignificant stenosis (<50% luminal narrowing), significant stenosis, or total or subtotal occlusion (>/=90% luminal narrowing). Gated SPECT findings were classified as normal or abnormal (reversible or fixed defects) and were allocated to the territory of one of the various coronary arteries. RESULTS: In coronary arteries with a calcium score of 10 or less, the corresponding myocardial perfusion was normal in 87% (n = 194/224). In coronary arteries with extensive calcifications (score > 400), the percentage of vascular territories with normal myocardial perfusion was lower, 54% (n = 13/24). Similarly, in most of the normal coronary arteries on multislice CT angiography, the corresponding myocardial perfusion was normal on SPECT (156/175, or 89%). In contrast, the percentage of normal SPECT findings was significantly lower in coronary arteries with obstructive lesions (59%) or with total or subtotal occlusions (8%) (P < 0.01). Nonetheless, only 48% of vascular territories with normal perfusion corresponded to normal coronary arteries on multislice CT angiography, whereas insignificant and significant stenoses were present in, respectively, 40% and 12% of corresponding coronary arteries. CONCLUSION: Although a relationship exists between the severity of CAD on multislice CT and myocardial perfusion abnormalities on SPECT, analysis on a regional basis showed only moderate agreement between observed atherosclerosis and abnormal perfusion. Accordingly, multislice CT and gated SPECT provide complementary rather than overlapping information, and further studies should address how these 2 modalities can be integrated to optimize patient management.

Aged↗
PubMed2005

Intraatrial repair of transposition of the great arteries: use of MR imaging after exercise to evaluate regional systemic right ventricular function.

PURPOSE: To prospectively assess regional systemic right ventricular (RV) function at rest and in response to exercise by using magnetic resonance (MR) imaging in patients who have undergone surgical correction at the atrial level for transposition of the great arteries (TGA). MATERIALS AND METHODS: Informed consent was obtained, and the medical review board approved this study. In 25 adult patients (mean age, 25.8 years +/- 4.7 [standard deviation]; 13 men) who had undergone correction for TGA (23.4 years +/- 4.9 after surgery) and 11 healthy volunteers (mean age, 27.4 years +/- 2.7; six men), systemic ventricular function was assessed with MR imaging (turbo field echo-planar imaging) at rest and during supine bicycle exercise. Regional wall thickness and wall thickening of the systemic RV were assessed and compared with those of the left ventricle in healthy volunteers by two investigators working together. Regional wall parameters were calculated by using the three-dimensional centerline method. Independent-samples t test and paired-samples t test were used for statistical analysis. RESULTS: Ejection fraction of the systemic RV did not increase after exercise (56% +/- 8 at rest to 55% +/- 7 after exercise, P = .196). Mean RV wall thickening was impaired in patients with TGA at all levels both at rest and in response to exercise (P < .05). Moreover, the free wall and the anterior wall of the systemic RV had a smaller end-systolic thickness and a diminished thickening at rest and after exercise compared with findings in the normal left ventricle (P < .05). CONCLUSION: The systemic RV of patients after intraatrial correction for TGA reveals regional functional disturbances at rest and in response to exercise.

Adult↗
PubMed2005

Time course of diastolic and systolic function improvement after pulmonary valve replacement in adult patients with tetralogy of Fallot.

OBJECTIVES: The aim of this research was to assess right ventricular diastolic and systolic function before and after pulmonary valve replacement (PVR) in adult patients after repair of tetralogy of Fallot. BACKGROUND: Pulmonary valve replacement (PVR) in adult patients late after repair of tetralogy of Fallot leads to rapid improvement of right ventricular (RV) systolic function. METHODS: A total of 16 patients and 8 healthy subjects were included. Median age at initial repair was 4.9 (0.9 to 13.1) years, and mean age at PVR was 28.7 (19.5 to 45.6) years. Cardiac magnetic resonance imaging was performed before and 8 and 22 months after PVR. Right ventricular volumes and function as well as RV in- and outflow patterns were assessed. RESULTS: The volume of the early filling of the RV (Evol) increased from 49.8 +/- 14.7 ml to 53.8 +/- 19.3 ml (not significant) and 62.0 +/- 18.9 ml, respectively (p < 0.05), whereas the volume of the atrial contraction (Avol) remained unchanged. Consequently, the Evol/Avol ratio increased from 1.4 +/- 0.7 before PVR to 1.6 +/- 0.7 at 8 months (not significant) and 2.3 +/- 1.2 at 22 months (p < 0.01). The Evol/Avol ratio was not significantly different from the healthy subjects at 22 months, indicating late recovery of diastolic function. Systolic function improved rapidly after PVR; the indexed RV end-systolic volume decreased from 93.7 +/- 33.0 ml/m2 to 60.9 +/- 18.4 ml/m2 (p < 0.01) and 54.8 +/- 21.0 ml/m2 (p < 0.01). CONCLUSIONS: In adult patients late after total repair of Fallot, PVR leads to late improvement of diastolic function. We speculate that the rapid volume unloading after PVR increases systolic performance, whereas improvement in diastolic function requires long-term remodeling.

Adolescent↗
PubMed2005

MRI to evaluate left atrial and ventricular reverse remodeling after restrictive mitral annuloplasty in dilated cardiomyopathy.

BACKGROUND: Data on reverse remodeling of the left atrium (LA) and left ventricle (LV) after restrictive annuloplasty in patients with dilated cardiomyopathy are scarce, and follow-up studies are performed with echocardiography. METHODS AND RESULTS: Twenty patients with dilated cardiomyopathy and severe mitral regurgitation selected for restrictive mitral annuloplasty underwent serial MRI studies (within 1 week before surgery, and 2 months [n =18] and 1 year [n =13] after surgery). Early mortality was 10%; all patients were free from endocarditis and thromboembolism. New York Heart Association class improved from 3.2+/-0.4 to 1.2+/-0.9. Only 1 patient developed recurrent severe mitral regurgitation during follow-up and it was re-repaired. LA end-systolic volumes decreased significantly over time (from 165+/-48 mL to 109+/-23 mL to 111+/-28 mL; P < 0.01), as did LA end-diastolic volumes (from 92+/-32 mL to 71+/-22 mL to 75+/-17 mL; P = 0.01). LV end-diastolic volumes decreased significantly (from 244+/-56 mL to 184+/-54 mL to 195+/-67 mL; P < 0.01), whereas end-systolic volumes did not change significantly. LV ejection fraction increased significantly (from 35+/-8% to 46+/-13% to 46+/-15%; P < 0.01) and LV mass decreased significantly (from 150+/-43 grams to 132+/-39 grams to 136+/-33 grams; P = 0.02). CONCLUSIONS: Restrictive annuloplasty in patients with dilated cardiomyopathy yielded excellent clinical results associated with significant LA and LV reverse remodeling over time as demonstrated by MRI.

Adult↗
PubMed2005

Global and regional left ventricular function assessment with 16-detector row CT: comparison with echocardiography and cardiovascular magnetic resonance.

AIMS: To compare multidetector row computed tomography (MDCT) global and regional left ventricular (LV) function assessment with echocardiography and cardiovascular magnetic resonance (CMR). METHODS AND RESULTS: In 25 patients, who were referred for noninvasive angiography with 16-detector row CT, LV function assessment was also performed. A subsequent echocardiogram was performed, and in a subgroup of patients, CMR examination was completed to evaluate LV function. For global function assessment, the LV ejection fraction (LVEF) was calculated. Regional LV function was scored using a 17-segment model and a 4-point scoring system. MDCT agreed well with echocardiography for the assessment of LVEF (r=0.96; bias 0.54%; p<0.0001) and regional LV function (kappa=0.78). Eight patients had no contra-indications and gave informed consent for CMR examination. A fair correlation between MDCT and CMR was demonstrated in the assessment of LVEF (r=0.86; bias -1.5%; p<0.01). Regional LV function agreement between MDCT and CMR was good (kappa=0.86). CONCLUSION: MDCT agreed well with both echocardiography and CMR in the assessment of global and regional LV function. Global and regional LV function may accurately be evaluated by 16-detector row CT, and can be added to a routine CT image analysis protocol without need for additional contrast or imaging time.

Aged↗
PubMed2005

Right ventricular dysfunction and pulmonary obstruction index at helical CT: prediction of clinical outcome during 3-month follow-up in patients with acute pulmonary embolism.

PURPOSE: To retrospectively quantify right ventricular dysfunction (RVD) and the pulmonary artery obstruction index at helical computed tomography (CT) on the basis of various criteria proposed in the literature and to assess the predictive value of these CT parameters for mortality within 3 months after the initial diagnosis of pulmonary embolism (PE). MATERIALS AND METHODS: Institutional review board approval was obtained, and informed consent was not required for retrospective study. In 120 consecutive patients (55 men, 65 women; mean age +/- standard deviation, 59 years +/- 18) with proved PE, two readers assessed the extent of RVD by quantifying the ratio of the right ventricle to left ventricle short-axis diameters (RV/LV) and the pulmonary artery to ascending aorta diameters, the shape of the interventricular septum, and the extent of obstruction to the pulmonary artery circulation on helical CT images, which were blinded for clinical outcome in consensus reading. Regression analysis was used to correlate these parameters with patient outcome. RESULTS: CT signs of RVD (RV/LV ratio, >1.0) were seen in 69 patients (57.5%). During follow-up, seven patients died of PE. Both the RV/LV ratio and the obstruction index were shown to be significant risk factors for mortality within 3 months (P = .04 and .01, respectively). No such relationship was found for the ratio of the pulmonary artery to ascending aorta diameters (P = .66) or for the shape of the interventricular septum (P = .20). The positive predictive value for PE-related mortality with an RV/LV ratio greater than 1.0 was 10.1% (95% confidence interval [CI]: 2.9%, 17.4%). The negative predictive value for an uneventful outcome with an RV/LV ratio of 1.0 or less was 100% (95% CI: 94.3%, 100%). There was a 11.2-fold increased risk of dying of PE for patients with an obstruction index of 40% or higher (95% CI: 1.3, 93.6). CONCLUSION: Markers of RVD and pulmonary vascular obstruction, assessed with helical CT at baseline, help predict mortality during follow-up.

Acute Disease↗
PubMed2005

Which parameters on magnetic resonance imaging determine Q waves on the electrocardiogram?

Studies have demonstrated that patients with Q-wave infarctions on the electrocardiogram (ECG) frequently have nontransmural scar formation, whereas non-Q-wave infarctions may have transmural scars. The precise pathophysiologic substrate that underlies Q waves remains unclear. Magnetic resonance imaging (MRI) is the preferred technique to evaluate patients who have infarction because information can be obtained on function, contractile reserve (viability), and scar tissue. Consecutive patients (n = 69) who had coronary artery disease and a history of myocardial infarction underwent MRI; the protocol included MRI at rest, small-dose dobutamine MRI, and contrast-enhanced MRI. Parameters included left ventricular ejection fraction, left ventricular volumes, end-diastolic wall thickness and contractile reserve in the infarct region, transmurality and spatial extent of scar tissue, total scar score, and quantified percent left ventricular scar tissue. MRI data were related to the presence/absence of Q waves on the ECG. Q waves were present in 39 patients (57%). Univariate analysis identified transmurality, spatial extent, total scar score, and quantified percent scar tissue as predictors of Q waves. Multivariate analysis demonstrated that quantified percent scar tissue was the single best predictor of Q waves on the ECG. A cut-off value of 17% infarcted tissue of the left ventricle yielded a sensitivity and specificity of 90% to predict the presence/absence of Q waves. When quantified percent scar tissue was removed from the model, spatial extent of infarction was the best predictor. Thus, Q waves on the ECG correlate best with quantified percent scar tissue on contrast-enhanced MR images.

Aged↗
PubMed2005

Feasibility of tissue magnetic resonance imaging: a pilot study in comparison with tissue Doppler imaging and invasive measurement.

OBJECTIVES: This research was intended to determine the feasibility of tissue magnetic resonance (MR) imaging in comparison with tissue Doppler imaging and its potential implications for the estimation of filling pressure, in comparison with invasive measurement. BACKGROUND: Evaluation of diastolic function using MR imaging is commonly confined to the study of transmitral flow. However, transmitral flow is unreliable for the estimation of left ventricular (LV) filling pressures in hypertrophy and normal systolic function. Normalizing early mitral velocity (E) for the influence of myocardial relaxation by combining E with early diastolic mitral septal tissue velocity (Ea) provides better Doppler estimates of filling pressures. METHODS: Eighteen patients with hypertensive heart disease (LV mass index: 114 +/- 21 g/m(2)), absence of valvular regurgitation, and with normal or mildly reduced systolic function (LV ejection fraction: 57.6 +/- 6.5%) referred for cardiac catheterization, underwent consecutive measurement of mitral flow and septal tissue velocities with phase-contrast MR and Doppler. These data were compared with mean pulmonary capillary wedge pressure (PCWP). RESULTS: There was a strong relation between MR (11.6 +/- 4.3) and Doppler-assessed (12.1 +/- 3.5) E/Ea (95% confidence interval of -1.5 to 0.5) (r = 0.89, p < 0.0001). In addition, E/Ea related strongly to invasively measured PCWP (MR: r = 0.80, p < 0.0001 and Doppler: r = 0.85, p < 0.0001). CONCLUSIONS: Tissue MR imaging is a feasible method to assess Ea. Combining E and Ea allowed similar estimation of filling pressure by MR and Doppler, in good agreement with invasive measurement. The potential confounding effect of valvular regurgitation needs further study.

Blood Flow Velocity↗
PubMed2005

Noninvasive coronary imaging and assessment of left ventricular function using 16-slice computed tomography.

In recent years, multislice computed tomography (MSCT) has been demonstrated to be a feasible imaging modality for noninvasive coronary angiography and left ventricular function analysis. The present study evaluated overall performance of 16-slice MSCT in the detection of significant coronary artery disease, stent, or bypass graft stenosis in combination with global left ventricular function analysis. Forty-five patients underwent 16-slice MSCT. Multislice computed tomograms were used to evaluate the presence of significant coronary artery stenoses (>/=50% decrease in luminal diameter) in native coronary segments, bypass grafts, and coronary stents and were compared with conventional coronary angiograms. In addition, left ventricular ejection fraction was calculated and compared with 2-dimensional echocardiography. MSCT was performed successfully in all patients. A close correlation between MSCT and 2-dimensional echocardiography was demonstrated for the assessment of left ventricular ejection fraction (y = 0.93x +3.33, r = 0.96, p <0.001). A total of 298 of native coronary artery segments (94%) were evaluated with MSCT, whereas 81 of 94 grafts (85%) and 41 of 52 coronary stents (79%) were also evaluated. For all segments, overall sensitivity, specificity, and positive and negative predictive values were 85%, 89%, 71%, and 95%, respectively. In conclusion, 16-slice MSCT is a feasible modality for noninvasive evaluation and exclusion of coronary artery disease in patients who present with chest pain.

Contrast Media↗
PubMed2005

Noninvasive visualization of the cardiac venous system using multislice computed tomography.

OBJECTIVES: We sought to evaluate the value of multislice computed tomography (MSCT) to depict the cardiac venous anatomy. BACKGROUND: During cardiac resynchronisation therapy (CRT), left ventricular (LV) pacing is established by a pacemaker lead in a tributary of the coronary sinus (CS). Knowledge of the CS anatomy and variations may facilitate the implantation of LV leads. METHODS: The MSCT scans of 38 patients (34 men; age 60 +/- 12 years) were studied. Anatomical variants were divided in three groups, dependent on the continuity of the cardiac venous system at the crux cordis. The CS ostium and distances between the main tributaries were measured. RESULTS: The most frequently observed variant had a separate insertion of the CS and the small cardiac vein in the right atrium (24 patients [63%]). In 11 patients (29%), there was continuity of the anterior and posterior venous system at the crux cordis. In three patients (8%), the posterior interventricular vein (PIV) did not connect to the CS. The mean distance from the PIV to the posterior vein of the left ventricle (PVLV) was 42.4 +/- 18.1 mm, from the PVLV to the left marginal vein (LMV) 39.9 +/- 15.6 mm, and from the LMV to the anterior interventricular vein 45.4 +/- 15.3 mm. The diameter of the CS ostium was 12.6 +/- 3.6 mm in anteroposterior and 15.5 +/- 4.5 mm in the superoinferior direction (p < 0.01). CONCLUSIONS: The anatomy of the CS and its tributaries can be evaluated using MSCT. As substantial variation in anatomy was observed, pre-implantation knowledge of the venous anatomy may help to decide whether transvenous LV lead placement for CRT is feasible.

Aged↗
PubMed2005

Right ventricular function late after total repair of tetralogy of Fallot.

Over the past decades, life expectancy in patients with congenital heart disease has increased dramatically. However, serious complications may develop late after total repair in infancy. These complications are usually the result of longstanding pulmonary regurgitation, which leads to dilatation of the right ventricle and an increased risk for severe arrhythmias. Therefore lifelong follow-up in these patients is required. Cardiac magnetic resonance imaging is the current imaging tool of choice because it offers superior imaging quality and enables accurate quantification of functional parameters such as flow volumes and systolic and diastolic performance.

Humans↗
PubMed2005

Reduction of QRS duration after pulmonary valve replacement in adult Fallot patients is related to reduction of right ventricular volume.

AIMS: Late after total correction, Fallot patients with a long QRS duration are prone to serious arrhythmias and sudden cardiac death. Pulmonary regurgitation is a common cause of right ventricular (RV) failure and QRS lengthening. We studied the effects of pulmonary valve replacement (PVR) on QRS duration and RV volume. METHODS AND RESULTS: Twenty-six consecutive Fallot patients were evaluated both pre-operatively and 6-12 months post-operatively by cardiac magnetic resonance (CMR). In this study, we present the computer-assisted analysis of the standard 12-lead electrocardiograms closest in time to the CMR studies. For the whole group, QRS duration shortened by 6+/-8 ms, from 151+/-30 to 144+/-29 ms (P=0.002). QRS duration decreased in 18 of 26 patients by 10+/-6 ms, from 152+/-32 to 142+/-31 ms. QRS duration remained constant or increased slightly in eight of 26 patients by 3+/-3 ms, from 148+/-27 to 151+/-25 ms. CMR showed a decrease in RV end-diastolic volume from 305+/-87 to 210+/-62 mL (P=0.000004). QRS duration changes correlated with RV end-diastolic volume changes (r=0.54, P=0.01). CONCLUSION: Our study shows that PVR reduces QRS duration. The amount of QRS reduction is related to the success of the operation, as expressed by the reduction in RV end-diastolic volume.

Adult↗
PubMed2005

Cardiac multidetector-row computed tomography in patients with unstable angina.

Ideally, information on coronary artery stenosis and left ventricular (LV) function is obtained in patients who have unstable angina to allow optimal risk stratification. The value of multidetector-row computed tomography (MDCT) was evaluated for a simultaneous assessment of coronary artery disease and global/regional LV function using a single acquisition. Twenty-five patients who had unstable angina underwent a single multidetector-row computed tomographic acquisition using a 4-slice multidetector-row computed tomographic system. Based on retrospective electrocardiographic gating, images and cine movies were reconstructed, which allowed 2 independent observers to analyze the 9 major coronary artery segments and global/regional LV function. Conventional angiography (with quantitative analysis) and echocardiography served as standards of reference, which were performed </=2 +/- 2.7 days and </=3 hours, respectively, after multidetector-row computed tomographic investigations. Sensitivity, specificity, positive and negative predictive values, and correlations were calculated. Of 225 coronary artery segments, 182 (81%) were assessable by MDCT. Significant (>/=50%) coronary artery stenosis was detected with sensitivities, specificities, and positive and negative predictive values of 95%, 91%, 85%, and 97% for observer 1 and 89%, 87%, 79%, and 94% for observer 2, respectively; the interobserver kappa value was 0.73. MDCT showed excellent agreement with echocardiography for regional wall motion (90%; kappa = 0.88) and LV ejection fraction (correlation 0.95%, mean difference 0.7 +/- 3.9). Thus, MDCT can simultaneously assess coronary artery disease and LV function in patients who have unstable angina. High accuracies in excluding significant coronary artery disease and in confirming normal LV function were observed, suggesting potential clinical use for screening of patients who present with symptoms of unstable angina.

Angina, Unstable↗
PubMed2005

Multislice computed tomography versus intracardiac echocardiography to evaluate the pulmonary veins before radiofrequency catheter ablation of atrial fibrillation: a head-to-head comparison.

OBJECTIVES: The purpose of this study was to perform a head-to-head comparison between multislice computed tomography (MSCT) and intracardiac echocardiography (ICE). BACKGROUND: Different imaging techniques have been used to visualize the pulmonary veins (PV) before radiofrequency ablation of atrial fibrillation. METHODS: The PV and their atrial insertion were evaluated in 42 patients (35 men, 49 +/- 9 years) admitted for ablation of PV ostia. Ostia were measured in two directions (anterior-posterior and superior-inferior) with MSCT. Two-dimensional (2-D) measurements of PV ostia were performed with ICE. Results were compared, considering MSCT as the gold standard. Venous ostium indexes were calculated by dividing MSCT measurements in the anterior-posterior direction and the superior-inferior direction. RESULTS: Common ostia of left PV were observed in 33 (79%) patients with MSCT and 31 (74%) patients with ICE. Common ostia of right PV were observed in 13 (31%) and 16 (38%) patients, respectively. Additional PV were observed in 13 (31%) patients with MSCT and in 7 (17%) patients with ICE. Ostial diameters by MSCT in the anterior-posterior direction were similar to 2-D measurements by ICE. By contrast, diameters by MSCT in the superior-inferior direction were significantly larger than 2-D diameters measured with ICE. Venous ostium indexes were 0.77 +/- 0.18 and 0.90 +/- 0.15 (p < 0.01) for left and right PV respectively, indicating an oval shape of particularly left PV ostia. CONCLUSIONS: Variation in PV anatomy is frequently observed with both techniques. The sensitivity for detection of additional branches is higher for MSCT. Results of measurements of PV ostia suggest an underestimation of ostial size by ICE. Three-dimensional imaging techniques, such as MSCT, are required to demonstrate an oval shape of PV ostia.

Adult↗