European Radiology

, Volume 29, Issue 12, pp 6816–6828 | Cite as

CT compared to MRI for functional evaluation of the right ventricle: a systematic review and meta-analysis

  • Hang Fu
  • Xuedong Wang
  • Kaiyue Diao
  • Shan Huang
  • Hui Liu
  • Yue Gao
  • Qin Zhao
  • Zhi-gang YangEmail author
  • Ying-kun GuoEmail author



Right ventricular function (RVF) is a strong predictor of adverse cardiac events; however, the reference standard for RVF assessment, MRI, is limited in some patients for whom accurate evaluation of RVF is essential, like those with COPD or non-MR compatible metal implants. We conducted this meta-analysis to evaluate whether CT was as accurate as MRI for the assessment of RVF.


We conducted a meta-analysis of studies retrieved from PubMed, Embase, and Cochrane Central searches to evaluate the differences and correlations between the following RVF parameters as measured by CT and MRI: end diastole volume (EDV), end systole volume (ESV), right ventricular ejection fraction (RVEF), and stroke volume (SV).


Sixteen studies that used disk summation (637 subjects) and three studies that used three-dimensional reconstruction were included. For the 16 studies, the pooled standard mean differences (95% confidence interval) were 1.04 (− 2.59, 4.67) for EDV, 1.22 (1.50, 3.95) for ESV, − 0.65 (− 2.60, 1.29) for RVEF, and − 0.37 (− 3.64, 2.90) for SV. The overall correlation coefficient (r) values were 0.98 for EDV, 0.95 for ESV, 0.98 for RVEF, and 0.97 for SV. The mean difference between the two methods was not statistically significant (overall effect Z test, p > 0.1).


CT can assess RVF with accuracy comparable to that of MRI. Thus, CT is a valid alternative to MRI.

Key Points

• CT could help clinicians to assess RVF as accurately as MRI can, with satisfactory repeatability.


Right ventricular function Computed tomography Magnetic resonance imaging Meta-analysis 



Confidence interval


Computed tomography


End diastole volume


End systole volume


Limit of agreement


Mean difference


Magnetic resonance


Magnetic resonance imaging


The Quality Assessment of Diagnostic Studies


Right ventricular


Right ventricular ejection fraction


Right ventricular function


Standard deviation


Stroke volume


Temporary resolution



This work was supported by the National Natural Science Foundation of China (81471722, 81771887, 81471721, 81771897) and Program for Young Scholars and Innovative Research Team in Sichuan Province of China (2017TD0005).

Compliance with ethical standards


The scientific guarantor of this publication is Ying-kun Guo.

Conflict of interest

The authors report no conflicts of interest.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because it is a meta-analysis.

Ethical approval

Institutional Review Board approval was not required because of the meta-analysis study design.

Study subjects or cohorts overlap

Study subjects and cohorts have been reported previously as detailed in the methods and results as well as reference.


• Performed at one institution

Supplementary material

330_2019_6228_MOESM1_ESM.docx (23 kb)
ESM 1 (DOCX 22.5 kb)


  1. 1.
    Haddad F, Doyle R, Murphy DJ, Hunt SA (2008) Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation 117:1717–1731CrossRefGoogle Scholar
  2. 2.
    Zornoff LA, Skali H, Pfeffer MA et al (2002) Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction. J Am Coll Cardiol 39:1450–1455CrossRefGoogle Scholar
  3. 3.
    Dini FL, Conti U, Fontanive P et al (2007) Right ventricular dysfunction is a major predictor of outcome in patients with moderate to severe mitral regurgitation and left ventricular dysfunction. Am Heart J 154:172–179CrossRefGoogle Scholar
  4. 4.
    Juillière Y, Barbier G, Feldmann L, Grentzinger A, Danchin N, Cherrier F (1997) Additional predictive value of both left and right ventricular ejection fractions on long-term survival in idiopathic dilated cardiomyopathy. Eur Heart J 18:276–280CrossRefGoogle Scholar
  5. 5.
    de Groote P, Millaire A, Foucher-Hossein C et al (1998) Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure. J Am Coll Cardiol 32:948–954CrossRefGoogle Scholar
  6. 6.
    Borer JS, Hochreiter CA, Supino PG, Herrold EM, Krieger KH, Isom OW (2002) Importance of right ventricular performance measurement in selecting asymptomatic patients with mitral regurgitation for valve surgery. Adv Cardiol 39:144–152CrossRefGoogle Scholar
  7. 7.
    Patscheider H, Lorbeer R, Auweter S et al (2018) Subclinical changes in MRI determined right ventricular volumes and function in subjects with prediabetes and diabetes. Eur Radiol 28:3105–3113CrossRefGoogle Scholar
  8. 8.
    Meune C, Khanna D, Aboulhosn J et al (2016) A right ventricular diastolic impairment is common in systemic sclerosis and is associated with other target-organ damage. Semin Arthritis Rheum 45:439–445CrossRefGoogle Scholar
  9. 9.
    Hoffmann R, Barletta G, von Bardeleben S et al (2014) Analysis of left ventricular volumes and function: a multicenter comparison of cardiac magnetic resonance imaging, cine ventriculography, and unenhanced and contrast-enhanced two-dimensional and three-dimensional echocardiography. J Am Soc Echocardiogr 27:292–301CrossRefGoogle Scholar
  10. 10.
    Moon JC, Lorenz CH, Francis JM, Smith GC, Pennell DJ (2002) Breath-hold FLASH and FISP cardiovascular MR imaging: left ventricular volume differences and reproducibility. Radiology 223:789–797CrossRefGoogle Scholar
  11. 11.
    Barkhausen J, Ruehm SG, Goyen M, Buck T, Laub G, Debatin JF (2001) MR evaluation of ventricular function: true fast imaging with steady-state precession versus fast low-angle shot cine MR imaging: feasibility study. Radiology 219:264–269CrossRefGoogle Scholar
  12. 12.
    Miller JD, Nazarian S, Halperin HR (2016) Implantable electronic cardiac devices and compatibility with magnetic resonance imaging. J Am Coll Cardiol 68:1590–1598CrossRefGoogle Scholar
  13. 13.
    Barkhausen J, Ruehm SG, Goyen M, Buck T, Laub G, Debatin JF (2016) Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis. Open Heart 3:e388Google Scholar
  14. 14.
    Pickett CA, Cheezum MK, Kassop D, Villines TC, Hulten EA (2015) Accuracy of cardiac CT, radionucleotide and invasive ventriculography, two- and three-dimensional echocardiography, and SPECT for left and right ventricular ejection fraction compared with cardiac MRI: a meta-analysis. Eur Heart J Cardiovasc Imaging 16:848–852CrossRefGoogle Scholar
  15. 15.
    Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310CrossRefGoogle Scholar
  17. 17.
    Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM, Kleijnen J (2003) The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 3:25CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Fisher RA (1915) Frequency distribution of the values of the correlation coefficients in samples from an indefinitely large population. Biometrika 10:507–521Google Scholar
  19. 19.
    Guo YK, Gao HL, Zhang XC, Wang QL, Yang ZG, Ma ES (2010) Accuracy and reproducibility of assessing right ventricular function with 64-section multi-detector row CT: comparison with magnetic resonance imaging. Int J Cardiol 139:254–262CrossRefGoogle Scholar
  20. 20.
    Jensen CJ, Wolf A, Eberle HC et al (2011) Accuracy and variability of right ventricular volumes and mass assessed by dual-source computed tomography: influence of slice orientation in comparison to magnetic resonance imaging. Eur Radiol 21:2492–2502CrossRefGoogle Scholar
  21. 21.
    Plumhans C, Mühlenbruch G, Rapaee A et al (2008) Assessment of global right ventricular function on 64-MDCT compared with MRI. AJR Am J Roentgenol 190:1358–1361CrossRefGoogle Scholar
  22. 22.
    Koch K, Oellig F, Oberholzer K et al (2005) Assessment of right ventricular function by 16-detector-row CT: comparison with magnetic resonance imaging. Eur Radiol 15:312–318CrossRefGoogle Scholar
  23. 23.
    Zhang XC, Yang ZG, Guo YK et al (2012) Assessment of right ventricular function for patients with rheumatic mitral stenosis by 64-slice multi-detector row computed tomography: comparison with magnetic resonance imaging. Chin Med J (Engl) 125:1469–1474Google Scholar
  24. 24.
    Huang X, Pu X, Dou R et al (2012) Assessment of right ventricular function with 320-slice volume cardiac CT: comparison with cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 28:87–92CrossRefGoogle Scholar
  25. 25.
    Fuchs A, Kühl JT, Lønborg J et al (2012) Automated assessment of heart chamber volumes and function in patients with previous myocardial infarction using multidetector computed tomography. J Cardiovasc Comput Tomogr 6:325–334CrossRefGoogle Scholar
  26. 26.
    Schroeder J, Peterschroeder A, Vaske B et al (2009) Cardiac volumetry in patients with heart failure and reduced ejection fraction: a comparative study correlating multi-slice computed tomography and magnetic resonance tomography. Reasons for intermodal disagreement. Clin Res Cardiol 98:739–747CrossRefGoogle Scholar
  27. 27.
    Elgeti T, Lembcke A, Enzweiler CN, Breitwieser C, Hamm B, Kivelitz DE (2004) Comparison of electron beam computed tomography with magnetic resonance imaging in assessment of right ventricular volumes and function. J Comput Assist Tomogr 28:679–685CrossRefGoogle Scholar
  28. 28.
    Gao Y, Du X, Liang L, Cao L, Yang Q, Li K (2012) Evaluation of right ventricular function by 64-row CT in patients with chronic obstructive pulmonary disease and cor pulmonale. Eur J Radiol 81:345–353CrossRefGoogle Scholar
  29. 29.
    Müller M, Teige F, Schnapauff D, Hamm B, Dewey M (2009) Evaluation of right ventricular function with multidetector computed tomography: comparison with magnetic resonance imaging and analysis of inter- and intraobserver variability. Eur Radiol 19:278–289CrossRefGoogle Scholar
  30. 30.
    Wang L, Zhang Y, Yan C et al (2013) Evaluation of right ventricular volume and ejection fraction by gated 18F-FDG PET in patients with pulmonary hypertension: comparison with cardiac MRI and CT. J Nucl Cardiol 20:242–252CrossRefGoogle Scholar
  31. 31.
    Maffei E, Messalli G, Martini C et al (2012) Left and right ventricle assessment with cardiac CT: validation study vs cardiac MR. Eur Radiol 22:1041–1049CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Raman SV, Shah M, McCarthy B, Garcia A, Ferketich AK (2006) Multi–detector row cardiac computed tomography accurately quantifies right and left ventricular size and function compared with cardiac magnetic resonance. Am Heart J 151:736–744CrossRefGoogle Scholar
  33. 33.
    Sugeng L, Mor-Avi V, Weinert L et al (2010) Multimodality comparison of quantitative volumetric analysis of the right ventricle. JACC Cardiovasc Imaging 3:10–18Google Scholar
  34. 34.
    Lembcke A, Dohmen PM, Dewey M et al (2005) Multislice computed tomography for preoperative evaluation of right ventricular volumes and function: comparison with magnetic resonance imaging. Ann Thorac Surg 79:1344–1351CrossRefGoogle Scholar
  35. 35.
    Takx RA, Moscariello A, Schoepf UJ et al (2012) Quantification of left and right ventricular function and myocardial mass: comparison of low-radiation dose 2nd generation dual-source CT and cardiac MRI. Eur J Radiol 81:e598–e604CrossRefGoogle Scholar
  36. 36.
    Yamasaki Y, Nagao M, Yamamura K et al (2014) Quantitative assessment of right ventricular function and pulmonary regurgitation in surgically repaired tetralogy of Fallot using 256-slice CT: comparison with 3-tesla MRI. Eur Radiol 24:3289–3299CrossRefGoogle Scholar
  37. 37.
    Guo YK, Yang ZG, Shao H, Deng W, Ning G, Dong ZH (2013) Right ventricular dysfunction and dilatation in patients with mitral regurgitation: analysis using ECG-gated multidetector row computed tomography. Int J Cardiol 167:1585–1590CrossRefGoogle Scholar
  38. 38.
    Jennifer L, Lezotte DC, Weitzenkamp DA, Allen LA, Salcedo EE (2012) Performance of 3-dimensional echocardiography in measuring left ventricular volumes and ejection fraction: a systematic review and meta-analysis. J Am Coll Cardiol 59:1799–1808CrossRefGoogle Scholar
  39. 39.
    Peng P, Lekadir K, Gooya A, Shao L, Petersen SE, Frangi AF (2016) A review of heart chamber segmentation for structural and functional analysis using cardiac magnetic resonance imaging. MAGMA 29:155–195CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Yang WJ, Chen KM, Liu B et al (2013) Contrast media volume optimization in high-pitch dual- source CT coronary angiography: feasibility study. Int J Cardiovasc Imaging 29:245–252CrossRefGoogle Scholar
  41. 41.
    Burghard P, Plank F, Beyer C et al (2018) Evaluation of right ventricular function by coronary computed tomography angiography using a novel automated 3D right ventricle volume segmentation approach: a validation study. Eur Radiol 28:5129–5136CrossRefGoogle Scholar
  42. 42.
    Gutberlet M, Schwinge K, Freyhardt P et al (2005) Influence of high magnetic field strengths and parallel acquisition strategies on image quality in cardiac 2D CINE magnetic resonance imaging: comparison of 1.5 T vs. 3.0 T. Eur Radiol 15:1586–1597CrossRefGoogle Scholar
  43. 43.
    Santoro F, Ieva R, Di Biase M, Brunetti ND (2015) Long live β-blockers in Takotsubo outflow obstruction! Rather with a short half-life. Can J Cardiol 31:1074–1077CrossRefGoogle Scholar
  44. 44.
    Oda S, Katahira K, Utsunomiya D et al (2015) Improved image quality at 256-slice coronary CT angiography in patients with a high heart rate and coronary artery disease: comparison with 64-slice CT imaging. Acta Radiol 56:1308–1314CrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Hang Fu
    • 1
  • Xuedong Wang
    • 2
  • Kaiyue Diao
    • 3
  • Shan Huang
    • 3
  • Hui Liu
    • 1
  • Yue Gao
    • 3
  • Qin Zhao
    • 3
  • Zhi-gang Yang
    • 3
    Email author
  • Ying-kun Guo
    • 1
    Email author
  1. 1.Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of EducationWest China Second University Hospital, Sichuan UniversityChengduChina
  2. 2.Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of EducationWest China Second University Hospital, Sichuan UniversityChengduChina
  3. 3.Department of Radiology, National Key Laboratory of Biotherapy, West China HospitalSichuan UniversityChengduChina

Personalised recommendations