Comparison of right ventricular volume measurements between axial and short axis orientation using steady‐state free precession magnetic resonance imaging

Abstract

Purpose:To compare right ventricular (RV) volume measurements and their reproducibility between axial and short axis orientation acquisition techniques. Materials and Methods:Measurements of RV volumes from data sets acquired in axial and short axis orientations were compared in 20 normal subjects. The observer variabilities were assessed and the left ventricle (LV) and RV stroke volumes (SV) were compared.Results: There was a significant and systematic difference in the EDV and ESV volumes between the axial and short axis methods. The latter method resulted in larger volumes (mean bias EDV 7.5 Ϯ 13.2, 4.7% difference; ESV 7.2 Ϯ 8.6, 10.7% difference). The axial method had lower intra-and interobserver variability than the short axis method. The standard deviation of the difference (SDD) and the limits of agreement were consistently lower for the axial method. The mean differences between LV and RV stroke volumes expressed as mean Ϯ 1 SD (r 2 ϭcorrelation coefficient) were: axial 7.6 Ϯ 9.1 (r 2 ϭ 0.93); and short axis 7.4 Ϯ 10.8 (r 2 ϭ 0.90). Conclusion:There is a significant systematic difference between volumes measured using the two different orientations. The axial orientation resulted in better inter-and intraobserver reproducibility. MAGNETIC RESONANCE IMAGING (MRI) is considered to be the most accurate imaging method for the evaluation of right ventricular (RV) volumes (1,2). MRI measurement of RV volumes has been validated with close correlation between RV and left ventricular (LV) stroke volumes and between RV stroke volumes and tricuspid flow measurements (3). The advantage of MRI is that it can offer unrestricted choice of scanning planes combined with three-dimensional coverage of the whole heart. Other imaging modalities, such as echocardiography and right ventriculography, are limited by the complex shape of the RV (4). Right ventriculography and tomographic-gated blood pool scintigraphy involve exposure to ionizing radiation (5).There is increased demand for assessment of the RV volumes and function, particularly in the long-term follow-up of patients with congenital heart disease (CHD) (6 -8). Serial imaging follow-up, to detect progressive RV dilation and functional deterioration, needs to be accurate and reproducible (9).MRI measurements of the RV volumes were originally validated in data acquired in the axial (transverse) orientation (3). However, it is currently common practice to acquire data for RV volumetric analysis in an axis aligned along the LV short axis. This has some potential advantages over the axial method. First, only one data set is required for both LV and RV measurements. Second, in the axial orientation, the partial volume effect of blood and myocardium on the inferior wall of the RV can make it difficult to identify the blood/myocardial boundary. This effect is particularly seen with segmented-k-space turbo gradient echo (TGE) pulse sequences that are limited by reduced contrast between the blood and myocardium at the endocardial border. This is because the contrast is larg...

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

“…These variables also showed the smallest variation for interobserver variability. The results of intraand interobserver variability analysis in this study are comparable to the results of other studies with SSFP for all variables (6,(25)(26)(27)(28). Therefore, CMR imaging is an accurate and reliable method for follow-up of these variables and can adequately assess changes in ventricular size and global ventricular performance.…”

“…For the right ventricle, assessment in the short axis orientation complicates identification of the position of the pulmonary and tricuspid valves. The axial orientation facilitates detection of the atrioventricular valve border and has a lower intraobserver and interobserver variability than the short axis method (27). However, acquisition in short axis orientation has two advantages: 1) only one dataset is required for biventricular measurements, and 2) there is less partial volume effect of blood and myocardium on the inferior wall of the RV compared to the axial orientation (27).…”

Features of Cardiac Remodeling, Associated With Blood Pressure and Fibrosis Biomarkers, Are Frequent in Subjects With Abdominal Obesity

“…Subjects with AO displayed a LV remodeling as assessed by a significant increase in LV mass (94±24 versus 84±21 g; P=0.034) without reaching LV hypertrophy 17 and in CRI (0.67±0.16 versus 0.60±0.10 g/mL; P=0.026) mainly because of the increase in LV mass. A significant increase in aminoterminal propeptide of type I procollagen (P<0.0001) accompanied by a decrease in type 1 collagen telopeptide (P<0.0001) concentrations were observed in AO.…”

The Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Nonischemic Dilated Cardiomyopathy

“…In contrast, cardiovascular magnetic resonance (CMR) allows noninvasive measurement of RVEF with high accuracy and reproducibility. [15][16][17][18][19] Despite the fact that CMR is now firmly established as the gold standard for RV assessment, 4,5,20 CMR data regarding the prevalence and prognostic implications of RVSD in DCM are lacking. We therefore sought to prospectively evaluate the prevalence and prognostic significance of RVSD, as assessed by CMR, in a broad spectrum of DCM patients.…”