title: Improved cardiac MRI volume measurements in patients with tetralogy of Fallot by independent end-systolic and end-diastolic phase selection.
abstract: OBJECTIVE
  To investigate to what extent cardiac MRI derived measurements of right ventricular (RV) volumes using the left ventricular (LV) end-systolic and end-diastolic frame misrepresent RV end-systolic and end-diastolic volumes in patients with tetralogy of Fallot (ToF) and a right bundle branch block.
  
  
  METHODS
  Sixty-five cardiac MRI scans of patients with ToF and a right bundle branch block, and 50 cardiac MRI scans of control subjects were analyzed. RV volumes and function using the end-systolic and end-diastolic frame of the RV were compared to using the end-systolic and end-diastolic frame of the LV.
  
  
  RESULTS
  Timing of the RV end-systolic frame was delayed compared to the LV end-systolic frame in 94% of patients with ToF and in 50% of control subjects. RV end-systolic volume using the RV end-systolic instead of LV end-systolic frame was smaller in ToF (median -3.3 ml/m(2), interquartile range -1.9 to -5.6 ml/m(2); p<0.001) and close to unchanged in control subjects. Using the RV instead of LV end-systolic and end-diastolic frame hardly affected RV end-diastolic volumes in both groups and ejection fraction in control subjects (54±4%, both methods), while increasing ejection fraction from 45±7% to 48±7% for patients with ToF (p<0.001). QRS duration correlated positively with the changes in the RV end-systolic volume (p<0.001) and RV ejection fraction obtained in ToF patients when using the RV instead of the LV end-systolic and end-diastolic frame (p = 0.004).
  
  
  CONCLUSIONS
  For clinical decision making in ToF patients RV volumes derived from cardiac MRI should be measured in the end-systolic frame of the RV instead of the LV.
authors: Department of Radiology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
authors: Hendrik G
authors: HG
authors: Freling
authors: Petronella G
authors: PG
authors: Pieper
authors: Karin M
authors: KM
authors: Vermeulen
authors: Jeroen M
authors: JM
authors: van Swieten
authors: Paul E
authors: PE
authors: Sijens
authors: Dirk J
authors: DJ
authors: van Veldhuisen
authors: Tineke P
authors: TP
authors: Willems
mesh_terms: D000328:Adult; D000368:Aged; D002037:Bundle-Branch Block; D002306:Cardiac Volume; D003971:Diastole; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D013599:Systole; D013771:Tetralogy of Fallot / Q000175:diagnosis* / Q000503:physiopathology*; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D055815:Young Adult
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