title: Calculation of right ventricular stroke volume in short-axis MR images using the equation of the tricuspid plane.
abstract: 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 (RVSV(DRAW)) 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 (RVSV(CONV)) 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 RVSV(DRAW) and LVSV was 0·1 ± 12·7 ml, while the mean difference between RVSV(CONV) 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.
authors.affiliation: School of Health and Medical Sciences, Örebro University, Örebro, Sweden. stina.jorstig@orebroll.se
authors.forename: Stina Hellstrandh
authors.initials: SH
authors.lastname: Jorstig
authors.forename: Anders
authors.initials: A
authors.lastname: Kähäri
authors.forename: Kent
authors.initials: K
authors.lastname: Emilsson
authors.forename: Per
authors.initials: P
authors.lastname: Thunberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology; D006331:Heart Diseases / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013318:Stroke Volume; D013548:Sweden; D014261:Tricuspid Valve / Q000473:pathology* / Q000503:physiopathology; D016278:Ventricular Function, Right; D055815:Young Adult