Comparison of long and short axis quantification of left ventricular volume parameters by cardiovascular magnetic resonance, with ex-vivo validationReport as inadecuate

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Journal of Cardiovascular Magnetic Resonance

, 13:40

First Online: 11 August 2011Received: 12 April 2011Accepted: 11 August 2011


BackgroundThe purpose of the study was to compare the accuracy and evaluation time of quantifying left ventricular LV, left atrial LA volume and LV mass using short axis SAX and long axis LAX methods when using cardiovascular magnetic resonance CMR.

Materials and methodsWe studied 12 explanted canine hearts and 46 patients referred for CMR 29 male, age 47 ± 18 years in a clinical 1.5 T CMR system, using standard cine sequences. In standard short axis stacks of various slice thickness values in dogs and 8 mm slice thickness gap 2 mm in patients, we measured LV volumes using reference slices in a perpendicular, long axis orientation using certified software. Volumes and mass were also measured in six radial long axis LAX views.

LV parameters were also assessed for intra- and inter-observer variability. In 24 patients, we also analyzed reproducibility and evaluation time of two very experienced > 10 years of CMR reading readers for SAX and LAX.

ResultsIn the explanted dog hearts, there was excellent agreement between ex vivo data and LV mass and volume data as measured by all methods for both, LAX r = 0.98 and SAX r = 0.88 to 0.98. LA volumes, however, were underestimated by 13% using the LAX views. In patients, there was a good correlation between all three assessed methods r ≥ 0.95 for all. In experienced clinical readers, left-ventricular volumes and ejection fraction as measured in LAX views showed a better inter-observer reproducibility and a 27% shorter evaluation time.

ConclusionWhen compared to an ex vivo standard, both, short axis and long axis techniques are highly accurate for the quantification of left ventricular volumes and mass. In clinical settings, however, the long axis approach may be more reproducible and more time-efficient. Therefore, the rotational long axis approach is a viable alternative for the clinical assessment of cardiac volumes, function and mass.

Electronic supplementary materialThe online version of this article doi:10.1186-1532-429X-13-40 contains supplementary material, which is available to authorized users.

Helene Childs, Lucia Ma contributed equally to this work.

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Author: Helene Childs - Lucia Ma - Michael Ma - James Clarke - Myra Cocker - Jordin Green - Oliver Strohm - Matthias G Friedrich


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