Impact of bi-planar localization of the tricuspid valve on the evaluation of right ventricular functional parameters in the short axis plane

Int J Cardiovasc Imaging. 2020 Nov;36(11):2255-2263. doi: 10.1007/s10554-020-01941-2. Epub 2020 Sep 14.

Abstract

Primary objective was to evaluate by cardiac MRI the accuracy of right ventricular stroke volume (RVSV) measurement in the short-axis (SA) plane with cross-referencing of the tricuspid plane. 2D phase-contrast measurement at the main pulmonary artery (PSV) was the reference. Secondary objective was to analyze the reproducibility of RV functional parameters. In this single-center retrospective study, 41 patients (mean age 40 ± 18 years; age range 16-71 years; M/F sex ratio 51%) referred for various acquired and congenital cardiopathies underwent CMR including SA balanced steady state free precession imaging (b-SSFP). Right ventricular vertical long-axis and four chamber views were used for cross-referenced localization of the tricuspid valve. Right ventricular functional parameters were measured on three occasions by two observers using Syngo Via® (Siemens Healthineers, Erlangen, Germany). The Student t-test and Bland Altman plot were used to test for differences between RV stroke volumes derived from cine b-SSFP (RVSV) or 2D PC (PSV). Bland Altman plots, coefficient of variation (COV) and intraclass correlation coefficient (ICC) were used to evaluate intra- and inter-observer reproducibility of RVSV, RVED and RVES volumes, and RV ejection fraction. There was high correlation (r = 0.94) and no significant difference between RVSV and PSV (83 ± 20 mL vs. 81 ± 21 mL p > 0.05). Intra- (ICC: 0.95; COV: 6.2) and inter-observer reliability (ICC: 0.91; COV: 8.9) of RVSV measurements were excellent. Finally, intra- and inter-observer reproducibility was excellent for RVEF, RVEDV and RVESV. Right ventricular stroke volumes can be routinely derived from SA analysis using cross-referenced localization of the atrioventricular plane. Moreover, all right ventricular systolic function parameters are highly reproducible when using this technique.

Keywords: Blood flow velocity; Cine magnetic resonance imaging; Heart ventricles; Ventricular function; right.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Retrospective Studies
  • Tricuspid Valve / physiopathology*
  • Ventricular Dysfunction, Right / diagnostic imaging*
  • Ventricular Dysfunction, Right / physiopathology*
  • Young Adult