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Calculation of right ventricular stroke volume in short-axis MR images using the equation of the tricuspid plane
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Department of Radiology, Örebro University Hospital, Örebro, Sweden.
Department of Clinical Physiology, Örebro University Hospital, Örebro, Sweden.
Department of Medical Physics, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0002-8351-3367
2012 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 32, no 1, p. 5-11Article in journal (Refereed) Published
Abstract [en]

Short-axis (SA) magnetic resonance (MR) images are commonly planned parallel to the left atrioventricular valve. This orientation leads to oblique slices of the right ventricle (RV) with subsequent difficulties in separating the RV from the right atrium in the SA images. The insertion points of the tricuspid valve (TV) in the myocardium can be clearly identified in the right ventricle long axis (RVLA) and four-chamber (4CH) views. The purpose of this study was to develop a method that transfers the position of the tricuspid plane, as seen in the RVLA and 4CH views, to the SA images to facilitate the separation of the RV from the atrium. This methodology, termed Dissociating the Right Atrium from the Ventricle Volume (DRAW), was applied in 20 patients for calculations of right ventricular stroke volume (RVSV). The RVSV using DRAW (RVSVDRAW) was compared to left ventricular stroke volumes (LVSV) obtained from flow measurements in the ascending aorta. The RVSV was also determined using the conventional method (RVSVCONV) where the stack of images from the SA views are summarized, and a visual decision is made of the most basal slice to be included in the RV. The mean difference between RVSVDRAW and LVSV was 0.1 +/- 12.7 ml, while the mean difference between RVSVCONV and LVSV was 0.33 +/- 14.3 ml. Both the intra- and interobserver variability were small using the DRAW methodology, 0.6 +/- 3.5 and 1.7 +/- 2.7 ml, respectively. In conclusion, the DRAW method can be used to facilitate the separation of the RV and the atrium.

Place, publisher, year, edition, pages
Malden, USA: Wiley-Blackwell, 2012. Vol. 32, no 1, p. 5-11
Keywords [en]
Atrioventricular, cardiovascular magnetic resonance imaging, image analysis, right atrium, right ventricle, separating, tricuspid valve, ventricular function
National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine; Cardiology
Identifiers
URN: urn:nbn:se:oru:diva-21715DOI: 10.1111/j.1475-097X.2011.01047.xISI: 000297928900002PubMedID: 22152073Scopus ID: 2-s2.0-83555164864OAI: oai:DiVA.org:oru-21715DiVA, id: diva2:504967
Note

Funding Agencies:

Research Committee of Örebro County Council 

European Union

Available from: 2012-02-22 Created: 2012-02-20 Last updated: 2018-08-27Bibliographically approved
In thesis
1. On the assessment of right ventricular function using cardiac magnetic resonance imaging and echocardiography
Open this publication in new window or tab >>On the assessment of right ventricular function using cardiac magnetic resonance imaging and echocardiography
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) imaging are two commonly used imaging modalities for evaluating the size and function of the heart. There are advantages and disadvantages associated with both modalities when examining the right ventricle (RV).

The RV is positioned partly behind the sternum and lung, sometimes causing shadows in the TTE images. This along with the complex shape of the RV makes volume calculations challenging by 2D TTE. CMR is considered to be the reference method for volume calculations of the ventricles. The valve separating the RV from the right atrium is however often oblique compared to the valve separating the left ventricle from the left atrium. This complicates RV volume calculations using conventional CMR short-axis stack images. The aim of this thesis was to find ways to improve the RV stroke volume and ejection fraction calculations using TTE and CMR.

A method, transferring the position of the tricuspid plane from RV long-axis images to short-axis images, was developed to improve the separation of the right atrium from the RV when calculating RV stroke volumes by CMR. The method provided calculations of RV stroke volumes with good agreement to reference volumes. Further, the movements contributing to the RV stroke volume was studied aiming to find new ways of calculating RV stroke volumes and ejection fraction by TTE. A model for RV stroke volume and ejection fraction calculations was evaluated showing underestimation of stroke volumes by TTE compared to CMR, which probably depend on differences in distance measurements using the two modalities. The model provided, however, promising results for ejection fraction calculations which was validated in a study of 37 participants that covered a wide range of EF.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2016. p. 79
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 152
Keywords
right ventricle, stroke volume, ejection fraction, cardiac magnetic resonance, ehocardiography
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-51662 (URN)978-91-7529-158-1 (ISBN)
Public defence
2016-11-18, Universitetssjukhuset, hörsal C3, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2016-08-15 Created: 2016-08-15 Last updated: 2019-03-26Bibliographically approved

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Jorstig, Stina HellstrandhEmilsson, KentThunberg, Per

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