ABSTRACT
PURPOSE: Quantification of left and right ventricular filling and ejection of localized and diffuse heart diseases with fast cine MR imaging in breath-hold technique. METHODS: 42 patients (14 idiopathic dilated cardiomyopathies (DCM), 13 hypertrophic cardiomyopathies (HCM) and 15 coronary artery diseases (CAD)) and 10 healthy volunteers were examined. Time-volume-curves of three left ventricular and one right ventricular slices were evaluated and peak ejection and filling rates (PER, PFR end-diastolic volume (EDV)/s) time to PER and PFR (TPER, TPFR ms) and time of end-systole (TSYS in % RR-intervall) were calculated. RESULTS: There were significant regional and left-/right-sided differences of the filling and ejection of both ventricles within and between the different groups. In DCM the left ventricular PFR was reduced (DCM 3.1 EDV/s; volunteers 4.9 EDV/s) and Z-SYS prolonged (DCM 50.1%; volunteers 35.4%). In CAD there were localized decreased filling rates in comparison to the normal volunteer group (left ventricle: basal: 2.9 and 6.3 EDV/s, apical: 4.4 and 6.3 EDV/s; right ventricle: 3.6 and 5.7 EDV/s). HCM typically showed an isovolumetric lengthening of the endsystole. CONCLUSIONS: Cardiac MR imaging in breath-hold technique is suitable for measuring contraction and relaxation disturbances of localized and diffuse heart diseases by means of ejection and filling volume indices.
Subject(s)
Cardiomyopathy, Dilated/diagnosis , Cardiomyopathy, Hypertrophic/diagnosis , Coronary Disease/diagnosis , Magnetic Resonance Imaging, Cine , Stroke Volume/physiology , Ventricular Dysfunction, Left/diagnosis , Ventricular Dysfunction, Right/diagnosis , Adolescent , Adult , Aged , Cardiomyopathy, Dilated/physiopathology , Cardiomyopathy, Hypertrophic/physiopathology , Coronary Disease/physiopathology , Female , Humans , Male , Middle Aged , Reference Values , Sensitivity and Specificity , Ventricular Dysfunction, Left/physiopathology , Ventricular Dysfunction, Right/physiopathology , Ventricular Function, Left/physiology , Ventricular Function, Right/physiologyABSTRACT
PURPOSE: Evaluation and comparison of localized and global left and right ventricular ejection and filling with fast cine MR imaging in the breath-hold technique. MATERIALS AND METHODS: 10 healthy volunteers were examined with a 1.5 Tesla unit and phased-array-coil using a segmented FLASH-2D sequence in breath-hold technique. Peak ejection and peak filling rates [PER, PFR end-diastolic volume (EDV)/s)]. time to PER and PFR [TPER, TPFR ms] and time of end-systole [TSYS in % RR-interval] of all slices (complete-slice-evaluation) were evaluated and compared to three left ventricular and one right ventricular slices (reduced three-slice-evaluation). RESULTS: There were significant regional left ventricular differences of PER (p = 0.002) and PFR (p = 0.007), but not of TPER and TPFR. Ejection and filling indices of the left ventricular middle slice were closest to the overall evaluation of all sections. In the left-/right-side comparison the right ventricular PFR was higher than the left ventricular (5.1 and 4.2 EDV/s) and the right ventricular TPFR was earlier than the left (92.2 and 123.5 ms). CONCLUSIONS: With fast cine techniques, regional and global left and right ventricular ejection and filling indices can be evaluated in addition to the global heart volume indices. The three-slice-evaluation represents a comprehensive, clear and time-saving method for daily routine.
Subject(s)
Magnetic Resonance Imaging, Cine/methods , Stroke Volume , Ventricular Function, Left , Ventricular Function, Right , Adult , Analysis of Variance , Diastole , Female , Humans , Magnetic Resonance Imaging, Cine/instrumentation , Magnetic Resonance Imaging, Cine/statistics & numerical data , Male , Reference Values , Respiration , Systole , Time FactorsABSTRACT
PURPOSE: To assess the accuracy of right- (RV) and left-ventricular (LV) heart volume and muscle mass determinations by cine MR imaging. MATERIALS AND METHODS: Ten subjects were examined twice by a segmented, ECG-triggered cine sequence in the short axis plane and breath-hold technique by two independent operators and again 4 weeks later by one of the operators. The contours were evaluated manually by two independent examiners and again four weeks later by one of the examiners. LV and RV end-diastolic and end-systolic volumes, stroke volume, cardiac output, ejection fraction (EF), and left-ventricular muscle mass were compared. RESULTS: The RV evaluation variations (RV-EF: 6.46%) were higher than the LV (LV-EF: 4.46%). The intra-examiner variations were smaller than the inter-examiner variations. The generally operators did not cause a significantly increased variation (LV-EF: 5.77%). In contrast, the repeat examinations at different times did lead to a significant increase in the variation (LV-EF: 10.15%). CONCLUSIONS: The rapid ECG-triggered cine MRI in breath-hold technique allows the simultaneous RV and LV, artefact-free determination of heart volumes and LV muscle mass. The LV volumes can be determined more accurately than the RV. The examiner has a distinct influence on the accuracy, the operator has a lesser effect. Physiological fluctuations of cardiac activity significantly influence the follow-up.
