To determine the accuracy of left ventricular ejection fractions (EFs) calculated from magnetic resonance (MR) images, 22 patients who underwent coronary angiography and left ventriculography were studied within 1-3 days by MR imaging. ECG-gated spin-echo 30-msec echo-delay images were obtained in end systole and end diastole in a plane through the long axis of the left ventricle perpendicular to the septum at a level through the aortic valve and apex. The area-length method was then used to calculate the EF from left ventriculograms and MR images. Angiographic EF correlated linearly with MR determinations. The mean differences in EF calculation between two observers were 5.0 +/- 6.9 for ventriculography and 2.7 +/- 7.8 for MR imaging. MR imaging, using image planes oriented to the left ventricular axes, can allow accurate EF calculation. This has the potential to be clinically useful in noninvasive evaluation of cardiac function.
Electrocardiographically gated magnetic resonance images were acquired in 20 subjects using a spin-echo pulse sequence. For optimizing the display of cardiac anatomy, a technique was developed which uses patient positioning in addition to alteration of gradient angle to select image planes. High-quality images were acquired in three basic cardiac projections: (1) the long axis of the left ventricle, through the aortic valve and apex, parallel to the interventricular septum, (2) the long axis of the left ventricle, perpendicular to the septum, and (3) the short axis of the left ventricle at multiple levels including outflow, papillary muscle, and apex. Images of the aorta included axial images at multiple levels and long-axis images oriented to display the plane of the aortic arch. Images of these planes are easily achieved and, in contrast to standard images orthogonal to the chest wall, provide a reproducible and logical display of cardiac anatomy.
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