Normal Human Right and Left Ventricular Mass, Systolic Function, and Gender Differences by Cine Magnetic Resonance Imaging

106

112

Purpose: To assess normal values for biventricular function, volumes, and mass with current cardiovascular magnetic resonance (CMR) imaging sequences in children. Materials and Methods:Included in the study were 60 healthy children aged 8 -17 years. A short axis set of contiguous slices was acquired with CMR imaging employing steady-state free precession. Biventricular end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), and mass were determined. Uni-and multivariate linear regression analyses were performed to study the interrelation of age, gender, and body surface area (BSA) on biventricular volumes and mass. The coefficient of variation was calculated for intra-and interobserver variability.Results: EF did not differ between boys and girls (mean LV-EF 69 Ϯ (SD) 5%, mean RV-EF 65 Ϯ 5%). BSA had good (EDV, mass) and modest (ESV) correlation with biventricular measurements. Gender appeared a significant modifier of these relations, whereas age had no independent contribution. The intra-and interobserver coefficient of variation was in the range 2.1%-13.9% for biventricular EDV, ESV, and mass. Conclusion:This study reveals gender-specific normative data for biventricular function, volumes, and mass in children age 8 -17 years that can be used as reference data in the follow-up of pediatric cardiac patients.

Section: Discussionsupporting

confidence: 83%

“…As has been demonstrated by others in adults (6,12,13,17), gender is a significant modifier of the relation between BSA and biventricular volumes and mass also in children.…”

Section: Discussionsupporting

confidence: 64%

Section: Cmr Analysismentioning

confidence: 99%

See 1 more Smart Citation

Normal biventricular function, volumes, and mass in children aged 8 to 17 years

Robbers‐Visser

Boersma

Helbing

2009

106

112

“…Their accuracy in determining left ventricular (LV) mass was also evaluated in animal experiments (10). Normal values were established for left and right ventricular volumes and function for both TGE as well as SSFP sequences, with SSFP sequences yielding significantly larger end-diastolic and end-systolic volumes (EDV and ESV, respectively) than TGE sequences (7,8,(11)(12)(13)(14)(15)(16)(17).Signal intensity in images acquired with SSFP sequences relies on T2/T1 ratio and does not depend on inflowing fresh blood, facilitating the delineation of papillary muscles and trabeculae as well as atrioventricular and semilunar valves (8). Contrast between intraventricular blood and myocardium as well as between myocardium and epicardial fat is significantly higher in images obtained with SSFP sequences compared to those acquired with TGE sequences (8,9), and thus…”

mentioning

confidence: 99%

Assessment of left ventricular function by breath‐hold cine MR imaging: Comparison of different steady‐state free precession sequences

Kunz

Oellig

Krummenauer

et al. 2005

Purpose:To compare steady-state free precession (SSFP) sequence protocols with different acquisition times (TA) and temporal resolutions (tRes) due to the implementation of a view sharing technique called shared phases for the assessment of left ventricular (LV) function by breath-hold cine magnetic resonance (MR) imaging. Materials and Methods:End-diastolic and end-systolic volumes (EDV, ESV) were measured in contiguous shortaxis slices with a thickness of 8 mm acquired in 10 healthy male volunteers. The following true fast imaging with steady-state precession (TrueFISP) sequence protocols were compared: protocol A) internal standard of reference, segmented: tRes 34.5 msec, TA 18 beats per slice; protocol B) segmented, shared phases: tRes 34.1 msec, TA 10 beats per slice; and protocol C) real-time, shared phases, parallel acquisition technique: tRes 47.3 msec, TA 24 beats for 12 slices covering the entire left ventricle. Results:Phase sharing leads to a significant decrease in EDV, stroke volume (SV), and ejection fraction (EF) (median difference -7.0 mL [*], -9.6 mL, and -3.4%, respectively, for protocol B; -15.3 mL, -13.3 mL, and -2.4% for protocol C; P ϭ 0.002, *P ϭ 0.021). The observed median difference of real-time EDV and SV estimates is of clinical relevance. Real-time cine MR imaging shows a greater variability of EDV and SV. No relevant differences in ESV were observed. Conclusion:The true cine frame duration of both shared phases sequence protocols exceeds the period of isovolumetric contraction (IVCT) of the left ventricle resulting in a systematic and significant underestimation of EDV and consequently SV and EF. SSFP sequence protocol parameters, particularly tRes and use of view sharing techniques, should therefore be known at follow-up examinations in order to be able to assess LV remodeling in patients with heart failure. CINE MAGNETIC RESONANCE (MR) imaging has beenshown to be the most accurate and reproducible method for the evaluation of cardiac ventricular volumes, function, and mass and is therefore regarded to be the standard of reference (1-4). Two different MR sequences are commonly used to assess cardiac function parameters non-invasively: segmented k-space turbo gradient echo (TGE) and steady-state free precession (SSFP) sequences.The accuracy of segmented k-space TGE sequences has been extensively evaluated, including animal experiments (5-8). The recently introduced SSFP sequences enable shorter acquisition times, allow higher in-plane resolutions, and provide better image quality (8,9). Their accuracy in determining left ventricular (LV) mass was also evaluated in animal experiments (10). Normal values were established for left and right ventricular volumes and function for both TGE as well as SSFP sequences, with SSFP sequences yielding significantly larger end-diastolic and end-systolic volumes (EDV and ESV, respectively) than TGE sequences (7,8,(11)(12)(13)(14)(15)(16)(17).Signal intensity in images acquired with SSFP sequences relies on T2/T1 ratio and does not depend on inflow...

“…Errors in CMR measurements are due to positional, physiological, planning, and measuring factors that comprise the interstudy variability (1,3,5,12,15,36,37). All of the subjects remained inside the magnet bore during the examination, so positional variability (12) was minimized.…”

Section: Discussionmentioning

confidence: 99%

Influence of positional and angular variation of automatically planned short‐axis stacks on quantification of left ventricular dimensions and function with cardiovascular magnetic resonance

Danilouchkine

Geest

Westenberg

et al. 2005

Purpose: To theoretically and experimentally investigate the influence of the automated cardiovascular magnetic resonance (CMR) scan planning pitfalls, namely inaccurate positioning and tilting of short-axis (SA) imaging planes, on quantification of the left ventricular (LV) dimensions and function. Materials and Methods:Eleven healthy subjects and eight patients underwent CMR. Manually and automatically planned SA sets were acquired. To obtain the quantitative measurements of LV function, one observer performed image analysis twice. The agreement between planning methods, as well as the decomposition of the total variation into interstudy and intraobserver components was measured. Results:The decomposition of the total variation showed that the interstudy factor accounts for 70 -85% of the total variation, while the rest is due to the intraobserver factor. Moreover, the relative contribution of the interstudy factor remains independent from errors in slice positioning and small angular deviation of SA stacks from the optimal orientation. Good agreement between the theoretical and measured variability factors was observed. Conclusion:Global LV function derived from the automatically planned CMR acquisitions yield accurate quantification of the human cardiovascular system. Inaccurate positioning and tilting of SA images does not affect the quantitative measurements of LV function. The computeraided system for automated CMR has proven clinical applicability.