Cardiac function measurement: CMR versus CT imaging using various reconstruction matrices

Objectives To evaluate the consistency of cardiac function measurements between cardiac magnetic resonance (CMR) and coronary computed tomography angiography (CCTA) across various reconstruction matrices and to provide clinical guidance for CT-derived parameters. Materials and methods This prospective single-center study enrolled patients who underwent CMR and CCTA examinations between January 2024 and April 2024. CCTA (index test) used 3 reconstruction matrices (CT₅₁₂, CT₂₅₆-₃, and CT₂₅₆-₀) compared with CMR (reference standard). Volumetric [left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), stroke volume index (SVI), mass, and myocardial wall thickness (MWT)] and strain parameters [global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS)] were analyzed. Consistency was assessed using Pearson’s correlation coefficient, Bland–Altman analysis, and one-way analysis of variance or Friedman tests. Results Fifty patients (mean age, 56.28 ± 13.14 years; 27 men) completed both examinations with diagnostic quality. CT₅₁₂ demonstrated superior performance compared with lower resolution matrices. Moderate to strong agreement was observed for LVESVI ( r = 0.61, P < 0.001), MWT ( r = 0.79, P < 0.001), and GCS ( r = 0.53, P < 0.001) between CT₅₁₂ and CMR. Significant differences were noted for LVEF ( P = 0.01), LVEDVI ( P = 0.04), mass ( P < 0.001), GRS ( P < 0.001), and GLS ( P < 0.001) between CMR and CT protocols. Conclusions CT-derived measurements show promise for LVESVI, MWT, and GCS with CT₅₁₂. However, LVEF, LVEDVI, LV mass, GRS and GLS are not interchangeable with CMR. Parameter‑specific caution is warranted when using CT for cardiac function assessment.