- Technologist presentation
- Open Access
Modified short axis geometry for left ventricular assessment in patients with hemodynamically significant pulmonary regurgitation
© Tipton et al; licensee BioMed Central Ltd. 2012
- Published: 1 February 2012
- Short Axis
- Intraclass Correlation Coefficient
- Transannular Patch
- SSFP Cine
- Excellent Interobserver Agreement
To determine the reliability of MRI LV measurements from a “modified” SA geometry compared with measurements from the standard SA geometry for repaired TOF patients with chronic pulmonary insufficiency.
Standard MRI assessment of ventricular volume and mass is based on a stack of “standard” short axis images orthogonal to the LV horizontal long axis. Recently, we showed a modified short axis (SA) geometry more accurately defines the tricuspid valve plane, and thereby provides more reliable right ventricular volume estimates in normal subjects and repaired TOF patients. In order to use the modified SA stack as a replacement for the standard SA stack in routine studies, we wanted to prove its reliability for LV measurements.
There was excellent agreement for all left ventricular metrics between the standard and the modified SA geometries. The ICC for the two methods was 0.93 (p<0.001) for end-diastolic volume, 0.91 (p<0.001) for end-systolic volume, and 0.91(p<0.001) for LV mass. The Bland-Altman analysis showed no significant bias with limits of agreement <5% (Fig.1(5)). There was also excellent interobserver agreement for the modified short axis geometry with ICCs ranging from 0.91 to 0.95 for the three measures and Bland-Altman limits of agreement <7%.
The modified SA geometry showed excellent agreement of LV volume measurments compared with the standard SA geometry in this series of chronic RV volume overload patients. These results combined with our previous work showing improved RV assessment by the modified SA geometry makes this the preferred geometry for standard evaluation of repaired TOF patients.
Abstract Summary Statement
In patients with chronic RV volume overload, a modified short axis geometry that has shown better reliability for RV volumetry also demonstrates excellent agreement for LV volumetry compared with the standard SA geometry.
There are no financial disclosures.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.