Reconstructed 4-chamber views compared with axial imaging for assessment of right ventricular enlargement on CT pulmonary angiograms

J Thromb Thrombolysis. 2009 Oct;28(3):342-7. doi: 10.1007/s11239-009-0331-5. Epub 2009 Mar 27.


Purpose: To test the hypothesis that right enlargement assessed from right ventricular/left ventricular (RV/LV) dimension ratios of computed tomographic (CT) angiograms are equivalent irrespective of whether measured on axial views or reconstructed 4-chamber views.

Methods: RV/LV dimension ratios were calculated from measurements on axial views, manually reconstructed 4-chamber views and computer generated reconstructed 4-chamber views of CT angiograms in 152 patients with PE.

Results: Paired readings of the axial view and manually reconstructed 4-chamber view showed agreement with RV/LV > or =1 or RV/LV <1 in 114 of 127 (89.8%). Paired readings also showed agreement in 119 of 127 (93.7%) with axial views and computer generated reconstructed 4-chamber views. The McNemar test showed no statistically significant difference between assessments of RV enlargement (RV/LV > or = 1) with any method.

Conclusion: Right ventricular enlargement can be determined from axial views on CT angiograms, which are readily and immediately available, without obtaining 4-chamber reconstructed views.

Publication types

  • Evaluation Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Angiography / methods*
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Hypertrophy, Right Ventricular / diagnostic imaging*
  • Lung / diagnostic imaging*
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / diagnostic imaging
  • Radiographic Image Interpretation, Computer-Assisted / methods
  • Tomography, X-Ray Computed / methods*