title: Evaluating the systemic right ventricle by cardiovascular magnetic resonance: short axis or axial slices?
abstract: OBJECTIVE
  To evaluate differences in functional parameters and reproducibility between short axis and axial slice orientation in the quantitative evaluation of the systemic right ventricle by cardiovascular magnetic resonance.
  
  
  METHODS
  Cross-sectional evaluation comparing two methods (Bland-Altman).
  
  
  METHODS
  Tertiary care outpatients.
  
  
  METHODS
  Quantitative cardiovascular magnetic resonance evaluation using short axis or axial slice orientation.
  
  
  METHODS
  Intraobserver variance, interobserver variance and systematic differences in systemic right ventricular volumes, ejection fraction, and mass between both methods.
  
  
  METHODS
  Twenty-two patients (mean age 33 ± 7 years) with systemic right ventricle (three with congenitally corrected transposition of the great arteries and 19 with atrially switched transposition of the great arteries).
  
  
  RESULTS
  Compared with short axis slices, analysis of axial slices resulted in higher end systolic volume (6.6%, P < .01), while mass (-10.8%, P < .01) and ejection fraction (-8.9%, P < .01) turned out lower. Intraobserver and interobserver reproducibility were similar for both methods when measuring end-diastolic and end-systolic volumes. However, ejection fraction and stroke volume were measured more consistently in axial orientation, while ventricular mass was measured more consistently in short axis orientation.
  
  
  CONCLUSIONS
  There are significant differences in volume, mass, and function between measurements in axial and short axis orientation. Ejection fraction and stroke volume, which have a high clinical relevance, were measured more consistently in axial slice orientation. Consequently, we recommend using axial slice orientation in patients with a systemic right ventricle.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands; The Netherlands Heart Institute, Utrecht, The Netherlands.
authors.forename: Teun
authors.initials: T
authors.lastname: van der Bom
authors.forename: Soha
authors.initials: S
authors.lastname: Romeih
authors.forename: Maarten
authors.initials: M
authors.lastname: Groenink
authors.forename: Petronella G
authors.initials: PG
authors.lastname: Pieper
authors.forename: Arie P J
authors.initials: AP
authors.lastname: van Dijk
authors.forename: Willem A
authors.initials: WA
authors.lastname: Helbing
authors.forename: Aeilko H
authors.initials: AH
authors.lastname: Zwinderman
authors.forename: Barbara J M
authors.initials: BJ
authors.lastname: Mulder
authors.forename: Berto J
authors.initials: BJ
authors.lastname: Bouma
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D013318:Stroke Volume; D016278:Ventricular Function, Right
keywords: Cardiovascular Magnetic Resonance Imaging; Functional Evaluation; Methodology; Systemic Right Ventricle; Transposition of the Great Arteries