Background Measurement of ventricular volumes and function using MRI is an important tool in pediatric congenital heart disease. However, normal values for children are sparce and analysis methods are inconsistent. Purpose To propose biventricular reference values in children for two MRI postprocessing (contouring) techniques. Study Type Retrospective. Subjects A total of 154 children from two institutions (13.9 ± 2.8 years; 101 male) that were referred for a clinical MRI study. Field Strength/Sequence 1.5 T; balanced steady‐state free precession (bSSFP) sequence. Assessment Left ventricular (LV) and right ventricular (RV) end‐diastolic and end‐systolic volumes (LVEDV, LVESV, RVEDV, RVESV) and end‐diastolic and end‐systolic myocardial mass (LVEDMM, LVESMM, RVEDMM, RVESMM) were measured from short‐axis images using two contouring techniques: 1) papillary muscles, trabeculations and the moderator band were included in the ventricular blood volume and excluded from the myocardial mass, 2) papillary muscles, trabeculations and the moderator band were excluded from the ventricular volume and included in the ventricular mass. Statistical Tests Univariable and multivariable linear regression models were used to evaluate relationships between sex, weight, height, body surface area (BSA) and age and volumetric results. Reference graphs and tables were created with the LMS‐method. Contouring techniques were compared by intraclass correlation, regression analysis and Bland–Altman plots. A P value < 0.05 was considered statistically significant. Results Height and BSA were significantly associated with LVESV (method 1) and with LVEDV and RVEDV (method 2). LVESV (method 2), RVESV (both methods), RVEDV (method 1), and LVEDMM and RVEDMM (both methods), showed significant associations with height and weight. LVSV and RVSV (both methods) were significantly associated with BSA and weight. RVESV (method 1) was significantly associated with age. Gender showed significant associations for all parameters. Data Conclusion The proposed pediatric reference values can be used in the diagnosis and follow‐up of congenital or acquired heart disease and for research purposes. Evidence Level 3 Technical Efficacy Stage 2
Background: Measurement of atrial volumes by MRI is becoming increasingly important in pediatric cardiac disorders. However, MRI normal values for atrial volumes in children are lacking. Purpose: To establish pediatric reference values for atrial volumes. Study Type: Retrospective. Subjects: A total of 155 healthy children from two large institutions (103 male, age 13.9 AE 2.8 years, range 4-18 years). Field Strength/Sequence: A 1.5 T; balanced steady-state free precession (bSSFP) sequence. Assessment: The monoplane and biplane area-length methods were used to measure minimal and maximal left and right atrial volumes (LA min , LA max , RA min , and RA max ) from four-chamber (4ch) and two-chamber (2ch) MR cine images. Centile charts and tables for atrial volumes were created. Statistical Tests: Descriptive statistics, lambda-mu-sigma (LMS)-method of Cole and Green, univariable and multivariable linear regression models. A P value < 0.05 was considered to be statistically significant. Results: In the multivariable linear model, body surface area was significantly associated with all atrial volumes and sex was significantly associated with RA volumes, LA volumes measured in the 2ch-view as well as biplane LA max. Average atrial volumes measured: monoplane 4ch: LA min 13.1 AE 4.8 mL/m 2 , LA max 33.4 AE 8.8 mL/m 2 , RA min 18.5 AE 6.8 mL/m 2 , RA max 33.2 AE 9.6 mL/m 2 ; monoplane 2ch: LA min 12.7 AE 4.9 mL/m 2 , LA max 30.5 AE 9.5 mL/m 2 ; biplane: LA min 12.3 AE 4.5 mL/m 2 , LA max 30.9 AE 8.7 mL/m 2 . Data Conclusion: Pediatric MRI reference values for atrial volumes have been provided. Technical Efficacy: 2 Evidence Level: 4
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