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      Normal right- and left ventricular volumes and myocardial mass in children measured by steady state free precession cardiovascular magnetic resonance

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          Abstract

          Background

          Quantification of ventricular volume by Steady State Free Precession (SSFP) cardiovascular magnetic resonance is accurate and reproducible. Normal values exist for adults, but are lacking for children.

          We sought to establish normal values for left and right ventricular volumes, mass and function in healthy children by using SSFP.

          Methods and results

          Fifty children (27 females, 23 males) without cardiovascular disease were evaluated. Median age was 11 years (range 7 months – 18 years), weight 35 kg (range 7–77 kg), height 146 cm (range 66–181 cm). Thirty-six examinations were performed with breath holding, 14 in freely breathing sedated children.

          Ventricular volumes and mass were measured in the end systolic and end diastolic phase on SSFP cine images acquired in a short axis plane as a stack of 12 contiguous slices covering full length of both ventricles.

          Regression analysis showed an exponential relationship between body surface area (BSA) and ventricular volumes and mass ( normal value = a*BSA b ). Normative curves for males and females are presented in relation to BSA for the enddiastolic volume, endsystolic volume and mass of both ventricles. Intra- and interobserver variability of the measurements was within the limits of 2% and 7% respectively, except for right ventricular mass (10%).

          Conclusion

          The exponential equation for calculation of normal values for each ventricular parameter and graphical display of normative curves for data acquired in healthy children by SSFP cardiovascular magnetic resonance are provided.

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          Most cited references22

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          Statistical methods for assessing agreement between two methods of clinical measurement.

          In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
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            Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences.

            To establish normal ranges of left ventricular (LV) and right ventricular (RV) dimensions as determined by the current pulse sequences in cardiac magnetic resonance imaging (MRI). Sixty normal subjects (30 male and 30 female; age range, 20-65) were examined; both turbo gradient echo (TGE) and steady-state free precession (SSFP) pulse sequences were used to obtain contiguous short-axis cine data sets from the ventricular apex to the base of the heart. The LV and RV volumes and LV mass were calculated by modified Simpson's rule. Normal ranges were established and indexed to both body surface area (BSA) and height. There were statistically significant differences in the measurements between the genders and between TGE and SSFP pulse sequences. For TGE the LV end-diastolic volume (EDV)/BSA (mL/m(2)) in males was 74.4 +/- 14.6 and in females was 70.9 +/- 11.7, while in SSFP in males it was 82.3 +/- 14.7 and in females it was 77.7 +/- 10.8. For the TGE the LV mass/BSA (g/m(2)) in males was 77.8 +/- 9.1 and in females it was 61.5 +/- 7.5, while in SSFP in males it was 64.7 +/- 9.3 and in females it was 52.0 +/- 7.4. For TGE the RV EDV/BSA (mL/m(2)) in males was 78.4 +/- 14.0 and in females it was 67.5 +/- 12.7, while in SSFP in males it was 86.2 +/- 14.1 and in females it was 75.2 +/- 13.8. We have provided normal ranges that are gender specific as well as data that can be used for age-specific normal ranges for both SSFP and TGE pulse sequences. Copyright 2003 Wiley-Liss, Inc.
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              Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance.

              We used state of the art CMR to define ranges for normal left ventricular volumes and systolic/diastolic function normalized to the influence of gender, body surface area and age. New CMR normalized ranges were modeled and displayed in graphical form for clinical use, with normalization for body surface area, gender, and age. The determination of normality, or the severity of abnormality, depends on the use of the appropriate reference ranges normalized to all 3 variables. These novel data have particular importance for clinical practice and clinical trials using CMR.
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                Author and article information

                Journal
                J Cardiovasc Magn Reson
                Journal of Cardiovascular Magnetic Resonance
                BioMed Central
                1097-6647
                1532-429X
                2009
                21 June 2009
                : 11
                : 1
                : 19
                Affiliations
                [1 ]Division of Pediatric Cardiology, University Children's Hospital, Zurich, Switzerland
                [2 ]Division of Anesthesiology, University Children's Hospital, Zurich, Switzerland
                [3 ]Departement of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland
                Article
                1532-429X-11-19
                10.1186/1532-429X-11-19
                2718870
                19545393
                49a50977-a4ee-489b-a9f2-644816f93924
                Copyright © 2009 Buechel et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 5 February 2009
                : 21 June 2009
                Categories
                Research

                Cardiovascular Medicine
                Cardiovascular Medicine

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