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ECHO 2013 / Cardiac Magnetic Resonance Imaging in the Adult Congenital Patient

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Magnetic Resonance Angiography

Cine Angiography

CMR in Adult CHD

•Program Description

•CMR Technique

•Reproducibility

•Other Strengths and Limitations

•Cases

MRI as the Gold Standard

•Global LV and RV volume measurements with a 3D approach that has no geometric assumptions

–Ex vivo validation with phantoms and casts

–In vivo validation with normal hearts, x-ray contrast ventriculograms

–Both stroke volumes and flow measurements

–LV and RV mass compared to autopsy and animal hearts

QUESTION

The reproducibility of volume measurements by cardiac MR is as good for the RV as for the LV.

1.True

2.False

CMR LV Interstudy Reproducibility

Grothues Am J Cardiol 2002

•20 normals, 20 HF, 20 LVH underwent 2 CMRs and 2 2D echocardiograms

CMR LV Interstudy Reproducibility

Grothues Am J Cardiol 2002

•Coefficient of Variability calculated as the SD of the differences divided by the mean of the parameter under consideration

•Coefficient of Variability

 

CMR

2DE

LV EDV

2.9% to 4.9%

5.5% to 10.5%

LV ESV *

4.4% to 9.2%

13.7% to 20.3%

LV EF *

2.4% to 7.3%

8.6% to 19.4%

LV Mass *

2.8% to 4.8%

11.6% to 15.7%

CMR RV Interstudy Reproducibility

Grothues Am Heart J 2004

•Same 60 subjects, age 51 + 18 yrs

•Coefficient of Variability

 

CMR

RV EDV

4.2% to 7.8%

RV ESV

8.1% to 18.1%

RV EF

4.3% to 10.4%

RV Mass

7.8% to 9.4%

•Correlation values lower for RV parameters (0.77- 0.98) than LV parameters (0.94-0.99)

CMR Reproducibility of RV

Measurements

Mooij J Magn Reson Imaging 2008

CMR 4-Chamber SSFP