Tetralogy of fallot: 3D velocity-encoded MR imaging for evaluation of right ventricular valve flow and diastolic function in patients after correction.
OBJECTIVE
To evaluate three-dimensional (3D) velocity-encoded (VE) magnetic resonance (MR) imaging, as compared with two-dimensional (2D) VE MR imaging, for assessment of pulmonary valve (PV) and tricuspid valve (TV) flow, with planimetry as the reference standard, and to evaluate diastolic function in patients with a corrected tetralogy of Fallot (TOF).


METHODS
Local institutional review board approval was obtained, and patients or their parents gave informed consent. Twenty-five patients with a corrected TOF (12 male, 13 female; mean age, 13.1 years +/- 2.7 [standard deviation]; age range, 8-18 years) and 19 control subjects (12 male, seven female; mean age, 14.1 years +/- 2.4; age range, 8-18 years) underwent planimetric MR imaging, 2D VE MR imaging, and 3D VE MR imaging for TV and PV flow evaluation. For evaluation of diastolic function, PV and TV flow were summated. Data were analyzed by using linear regression analysis, paired and unpaired t testing, and Bland-Altman plots.


RESULTS
Strong correlations between the 2D VE MR and 3D VE MR measurements of PV flow (for forward flow: r = 0.87, P < .01; for backward flow: r = 0.97, P < .01) were observed. With PV effective flow as a reference, 3D TV effective flow measurements were more accurate than 2D TV effective flow measurements: In patients, the mean 2D TV effective flow versus 2D PV effective flow difference was 17.6 mL +/- 11 (P < .001), and the mean 3D TV effective flow versus 3D PV effective flow difference was -1.2 mL +/- 4.7 (P = .22). Diastolic functional impairment in patients could be detected at 3D VE MR imaging diastolic assessment.


CONCLUSIONS
Three-dimensional VE MR imaging is accurate for PV flow assessment and is more accurate than 2D VE MR imaging for TV flow evaluation. Assessment of diastolic function with 3D VE MR imaging can facilitate ongoing research of diastolic dysfunction in patients with a corrected TOF.
van der Hulst
Annelies E
AE
Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, RC, Leiden, The Netherlands.
Westenberg
Jos J M
JJ
Kroft
Lucia J M
LJ
Bax
Jeroen J
JJ
Blom
Nico A
NA
de Roos
Albert
A
Roest
Arno A W
AA
D000293:Adolescent; D001783:Blood Flow Velocity; D016009:Chi-Square Distribution; D002648:Child; D003971:Diastole; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011664:Pulmonary Valve / Q000503:physiopathology; D011665:Pulmonary Valve Insufficiency / Q000503:physiopathology; D013771:Tetralogy of Fallot / Q000503:physiopathology* / Q000601:surgery; D014261:Tricuspid Valve / Q000503:physiopathology