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Figure 9c. Calculation of the RV ejection fraction with CT in a 67-year-old woman with massive PE (same patient as in Fig 7). (a) After ECG-gated CT pulmonary angiography, the box for short-axis reformation is applied inside the CT raw data volume (images at top of computer screen). Reformatted short-axis CT sections are usually 58 mm thick. Multiple series of reformatted images are obtained every 5%10% of the R-R cycle. (b) Computer screen shows series of short-axis images of the heart, which were generated every 10% of the R-R cycle. Manual contouring was then performed along the inner wall of the RV for each series by using dedicated software (Argus; Siemens Medical Solutions, Erlangen, Germany). (c) List of the results provided by the software shows that the end-systolic and end-diastolic volumes are dramatically enlarged, whereas the ejection fraction is reduced to 17%.