Skip to main content
Top
Published in: Journal of Cardiovascular Magnetic Resonance 1/2009

Open Access 01-12-2009 | Research

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

Authors: Emanuela Valsangiacomo Buechel, Thomas Kaiser, Clare Jackson, Achim Schmitz, Christian J Kellenberger

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2009

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Pattynama PM, Lamb HJ, Velde van der EA, Wall van der EE, de Roos A: Left ventricular measurements with cine and spin-echo MR imaging: a study of reproducibility with variance component analysis. Radiology. 1993, 187: 261-268.CrossRefPubMed Pattynama PM, Lamb HJ, Velde van der EA, Wall van der EE, de Roos A: Left ventricular measurements with cine and spin-echo MR imaging: a study of reproducibility with variance component analysis. Radiology. 1993, 187: 261-268.CrossRefPubMed
2.
go back to reference Kondo C, Caputo GR, Semelka R, Foster E, Shimakawa A, Higgins CB: Right and left ventricular stroke volume measurements with velocity- encoded cine MR imaging: in vitro and in vivo validation. AJR Am J Roentgenol. 1991, 157 (1): 9-16.CrossRefPubMed Kondo C, Caputo GR, Semelka R, Foster E, Shimakawa A, Higgins CB: Right and left ventricular stroke volume measurements with velocity- encoded cine MR imaging: in vitro and in vivo validation. AJR Am J Roentgenol. 1991, 157 (1): 9-16.CrossRefPubMed
3.
go back to reference Grothues F, Smith GC, Moon JC, Bellenger NG, Collins P, Klein HU, Pennell DJ: Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy. Am J Cardiol. 2002, 90: 29-34. 10.1016/S0002-9149(02)02381-0.CrossRefPubMed Grothues F, Smith GC, Moon JC, Bellenger NG, Collins P, Klein HU, Pennell DJ: Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy. Am J Cardiol. 2002, 90: 29-34. 10.1016/S0002-9149(02)02381-0.CrossRefPubMed
4.
go back to reference Buechel ER, Dave HH, Kellenberger CJ, Dodge-Khatami A, Pretre R, Berger F, Bauersfeld U: Remodelling of the right ventricle after early pulmonary valve replacement in children with repaired tetralogy of Fallot: assessment by cardiovascular magnetic resonance. Eur Heart J. 2005, 26: 2721-2727. 10.1093/eurheartj/ehi581.CrossRefPubMed Buechel ER, Dave HH, Kellenberger CJ, Dodge-Khatami A, Pretre R, Berger F, Bauersfeld U: Remodelling of the right ventricle after early pulmonary valve replacement in children with repaired tetralogy of Fallot: assessment by cardiovascular magnetic resonance. Eur Heart J. 2005, 26: 2721-2727. 10.1093/eurheartj/ehi581.CrossRefPubMed
5.
go back to reference Pattynama PM, Lamb HJ, Velde Van der EA, Geest Van der RJ, Wall Van der EE, De Roos A: Reproducibility of MRI-derived measurements of right ventricular volumes and myocardial mass. Magn Reson Imaging. 1995, 13: 53-63. 10.1016/0730-725X(94)00076-F.CrossRefPubMed Pattynama PM, Lamb HJ, Velde Van der EA, Geest Van der RJ, Wall Van der EE, De Roos A: Reproducibility of MRI-derived measurements of right ventricular volumes and myocardial mass. Magn Reson Imaging. 1995, 13: 53-63. 10.1016/0730-725X(94)00076-F.CrossRefPubMed
6.
go back to reference Carr JC, Simonetti O, Bundy J, Li D, Pereles S, Finn JP: Cine MR Angiography of the Heart with Segmented True Fast Imaging with Steady-State Precession. Radiology. 2001, 219: 828-834.CrossRefPubMed Carr JC, Simonetti O, Bundy J, Li D, Pereles S, Finn JP: Cine MR Angiography of the Heart with Segmented True Fast Imaging with Steady-State Precession. Radiology. 2001, 219: 828-834.CrossRefPubMed
7.
go back to reference Thiele H, Nagel E, Paetsch I, Schnackenburg B, Bornstedt A, Kouwenhoven M, Wahl A, Schuler G, Fleck E: Functional cardiac MR imaging with steady-state free precession (SSFP) significantly improves endocardial border delineation without contrast agents. J Magn Reson Imaging. 2001, 14: 362-367. 10.1002/jmri.1195.CrossRefPubMed Thiele H, Nagel E, Paetsch I, Schnackenburg B, Bornstedt A, Kouwenhoven M, Wahl A, Schuler G, Fleck E: Functional cardiac MR imaging with steady-state free precession (SSFP) significantly improves endocardial border delineation without contrast agents. J Magn Reson Imaging. 2001, 14: 362-367. 10.1002/jmri.1195.CrossRefPubMed
8.
go back to reference Moon JC, Lorenz CH, Francis JM, Smith GC, Pennell DJ: Breath-hold FLASH and FISP Cardiovascular MR Imaging: Left Ventricular Volume Differences and Reproducibility. Radiology. 2002, 223: 789-797. 10.1148/radiol.2233011181.CrossRefPubMed Moon JC, Lorenz CH, Francis JM, Smith GC, Pennell DJ: Breath-hold FLASH and FISP Cardiovascular MR Imaging: Left Ventricular Volume Differences and Reproducibility. Radiology. 2002, 223: 789-797. 10.1148/radiol.2233011181.CrossRefPubMed
9.
go back to reference Maceira AM, Prasad SK, Khan M, Pennell DJ: Reference right ventricular systolic and diastolic function normalized to age, gender and body surface area from steady-state free precession cardiovascular magnetic resonance. Eur Heart J. 2006, 27: 2879-2888. 10.1093/eurheartj/ehl336.CrossRefPubMed Maceira AM, Prasad SK, Khan M, Pennell DJ: Reference right ventricular systolic and diastolic function normalized to age, gender and body surface area from steady-state free precession cardiovascular magnetic resonance. Eur Heart J. 2006, 27: 2879-2888. 10.1093/eurheartj/ehl336.CrossRefPubMed
10.
go back to reference Maceira AM, Prasad SK, Khan M, Pennell DJ: Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2006, 8: 417-426. 10.1080/10976640600572889.CrossRefPubMed Maceira AM, Prasad SK, Khan M, Pennell DJ: Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2006, 8: 417-426. 10.1080/10976640600572889.CrossRefPubMed
11.
go back to reference Helbing WA, Rebergen SA, Maliepaard C, Hansen B, Ottenkamp J, Reiber JH, de Roos A: Quantification of right ventricular function with magnetic resonance imaging in children with normal hearts and with congenital heart disease. Am Heart J. 1995, 130: 828-837. 10.1016/0002-8703(95)90084-5.CrossRefPubMed Helbing WA, Rebergen SA, Maliepaard C, Hansen B, Ottenkamp J, Reiber JH, de Roos A: Quantification of right ventricular function with magnetic resonance imaging in children with normal hearts and with congenital heart disease. Am Heart J. 1995, 130: 828-837. 10.1016/0002-8703(95)90084-5.CrossRefPubMed
12.
go back to reference Lorenz CH: The range of normal values of cardiovascular structures in infants, children, and adolescents measured by magnetic resonance imaging. Pediatr Cardiol. 2000, 21: 37-46. 10.1007/s002469910006.CrossRefPubMed Lorenz CH: The range of normal values of cardiovascular structures in infants, children, and adolescents measured by magnetic resonance imaging. Pediatr Cardiol. 2000, 21: 37-46. 10.1007/s002469910006.CrossRefPubMed
13.
go back to reference Prader A, Largo RH, Molinari L, Issler C: Physical growth of Swiss children from birth to 20 years of age. First Zurich longitudinal study of growth and development. Helv Paediatr Acta Suppl. 1989, 52: 1-125.PubMed Prader A, Largo RH, Molinari L, Issler C: Physical growth of Swiss children from birth to 20 years of age. First Zurich longitudinal study of growth and development. Helv Paediatr Acta Suppl. 1989, 52: 1-125.PubMed
14.
go back to reference Inoue Y, Nomura Y, Nakaoka T, Watanabe M, Kiryu S, Okubo T, Ohtomo K: Effect of temporal resolution on the estimation of left ventricular function by cardiac MR imaging. Magnetic Resonance Imaging. 2005, 23: 641-645. 10.1016/j.mri.2005.04.004.CrossRefPubMed Inoue Y, Nomura Y, Nakaoka T, Watanabe M, Kiryu S, Okubo T, Ohtomo K: Effect of temporal resolution on the estimation of left ventricular function by cardiac MR imaging. Magnetic Resonance Imaging. 2005, 23: 641-645. 10.1016/j.mri.2005.04.004.CrossRefPubMed
15.
go back to reference Miller S, Simonetti OP, Carr J, Kramer U, Finn JP: MR Imaging of the heart with cine true fast imaging with steady-state precession: influence of spatial and temporal resolutions on left ventricular functional parameters. Radiology. 2002, 223: 263-269. 10.1148/radiol.2231010235.CrossRefPubMed Miller S, Simonetti OP, Carr J, Kramer U, Finn JP: MR Imaging of the heart with cine true fast imaging with steady-state precession: influence of spatial and temporal resolutions on left ventricular functional parameters. Radiology. 2002, 223: 263-269. 10.1148/radiol.2231010235.CrossRefPubMed
16.
go back to reference Lorenz CH, Walker ES, Morgan VL, Klein SS, Graham TP: Normal human right and left ventricular mass, systolic function, and gender differences by cine magnetic resonance imaging. J Cardiovasc Magn Reson. 1999, 1: 7-21. 10.3109/10976649909080829.CrossRefPubMed Lorenz CH, Walker ES, Morgan VL, Klein SS, Graham TP: Normal human right and left ventricular mass, systolic function, and gender differences by cine magnetic resonance imaging. J Cardiovasc Magn Reson. 1999, 1: 7-21. 10.3109/10976649909080829.CrossRefPubMed
17.
go back to reference Vinnakota KC, Bassingthwaighte JB: Myocardial density and composition: a basis for calculating intracellular metabolite concentrations. Am J Physiol Heart Circ Physiol. 2004, 286: H1742-1749. 10.1152/ajpheart.00478.2003.CrossRefPubMed Vinnakota KC, Bassingthwaighte JB: Myocardial density and composition: a basis for calculating intracellular metabolite concentrations. Am J Physiol Heart Circ Physiol. 2004, 286: H1742-1749. 10.1152/ajpheart.00478.2003.CrossRefPubMed
18.
go back to reference Papavassiliu T, Kuhl HP, Schroder M, Suselbeck T, Bondarenko O, Bohm CK, Beek A, Hofman MM, van Rossum AC: Effect of endocardial trabeculae on left ventricular measurements and measurement reproducibility at cardiovascular MR imaging. Radiology. 2005, 236: 57-64. 10.1148/radiol.2353040601.CrossRefPubMed Papavassiliu T, Kuhl HP, Schroder M, Suselbeck T, Bondarenko O, Bohm CK, Beek A, Hofman MM, van Rossum AC: Effect of endocardial trabeculae on left ventricular measurements and measurement reproducibility at cardiovascular MR imaging. Radiology. 2005, 236: 57-64. 10.1148/radiol.2353040601.CrossRefPubMed
19.
go back to reference Alfakih K, Plein S, Thiele H, Jones T, Ridgway JP, Sivananthan MU: Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences. J Magn Reson Imaging. 2003, 17: 323-329. 10.1002/jmri.10262.CrossRefPubMed Alfakih K, Plein S, Thiele H, Jones T, Ridgway JP, Sivananthan MU: Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences. J Magn Reson Imaging. 2003, 17: 323-329. 10.1002/jmri.10262.CrossRefPubMed
20.
go back to reference Mosteller RD: Simplified calculation of body-surface area. N Engl J Med. 1987, 317: 1098-PubMed Mosteller RD: Simplified calculation of body-surface area. N Engl J Med. 1987, 317: 1098-PubMed
21.
go back to reference Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986, 1: 307-310.CrossRefPubMed Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986, 1: 307-310.CrossRefPubMed
22.
go back to reference Sluysmans T, Colan SD: Theoretical and empirical derivation of cardiovascular allometric relationships in children. J Appl Physiol. 2005, 99: 445-457. 10.1152/japplphysiol.01144.2004.CrossRefPubMed Sluysmans T, Colan SD: Theoretical and empirical derivation of cardiovascular allometric relationships in children. J Appl Physiol. 2005, 99: 445-457. 10.1152/japplphysiol.01144.2004.CrossRefPubMed
23.
go back to reference Robbers-Vissers DBE, Helbing WA: Normal biventricular function, volumes, and mass in children aged 8 to 17 years. J Magn Reson Imaging. 2009, 29: 552-559.CrossRef Robbers-Vissers DBE, Helbing WA: Normal biventricular function, volumes, and mass in children aged 8 to 17 years. J Magn Reson Imaging. 2009, 29: 552-559.CrossRef
24.
go back to reference Alfakih K, Thiele H, Plein S, Bainbridge GJ, Ridgway JP, Sivananthan MU: Comparison of right ventricular volume measurement between segmented k-space gradient-echo and steady-state free precession magnetic resonance imaging. J Magn Reson Imaging. 2002, 16: 253-258. 10.1002/jmri.10164.CrossRefPubMed Alfakih K, Thiele H, Plein S, Bainbridge GJ, Ridgway JP, Sivananthan MU: Comparison of right ventricular volume measurement between segmented k-space gradient-echo and steady-state free precession magnetic resonance imaging. J Magn Reson Imaging. 2002, 16: 253-258. 10.1002/jmri.10164.CrossRefPubMed
25.
go back to reference Lange PE, Onnasch DG, Schaupp GH, Zill C, Heintzen PH: Size and function of the human left and right ventricles during growth. Normative angiographic data. Pediatr Cardiol. 1982, 3: 205-211. 10.1007/BF02240454.CrossRefPubMed Lange PE, Onnasch DG, Schaupp GH, Zill C, Heintzen PH: Size and function of the human left and right ventricles during growth. Normative angiographic data. Pediatr Cardiol. 1982, 3: 205-211. 10.1007/BF02240454.CrossRefPubMed
26.
go back to reference Gutgesell HP, Rembold CM: Growth of the human heart relative to body surface area. Am J Cardiol. 1990, 65: 662-668. 10.1016/0002-9149(90)91048-B.CrossRefPubMed Gutgesell HP, Rembold CM: Growth of the human heart relative to body surface area. Am J Cardiol. 1990, 65: 662-668. 10.1016/0002-9149(90)91048-B.CrossRefPubMed
27.
go back to reference Sievers B, Kirchberg S, Bakan A, Franken U, Trappe HJ: Impact of papillary muscles in ventricular volume and ejection fraction assessment by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2004, 6: 9-16. 10.1081/JCMR-120027800.CrossRefPubMed Sievers B, Kirchberg S, Bakan A, Franken U, Trappe HJ: Impact of papillary muscles in ventricular volume and ejection fraction assessment by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2004, 6: 9-16. 10.1081/JCMR-120027800.CrossRefPubMed
28.
go back to reference Grothues F, Moon JC, Bellenger NG, Smith GS, Klein HU, Pennell DJ: Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. Am Heart J. 2004, 147: 218-223. 10.1016/j.ahj.2003.10.005.CrossRefPubMed Grothues F, Moon JC, Bellenger NG, Smith GS, Klein HU, Pennell DJ: Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. Am Heart J. 2004, 147: 218-223. 10.1016/j.ahj.2003.10.005.CrossRefPubMed
Metadata
Title
Normal right- and left ventricular volumes and myocardial mass in children measured by steady state free precession cardiovascular magnetic resonance
Authors
Emanuela Valsangiacomo Buechel
Thomas Kaiser
Clare Jackson
Achim Schmitz
Christian J Kellenberger
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2009
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/1532-429X-11-19

Other articles of this Issue 1/2009

Journal of Cardiovascular Magnetic Resonance 1/2009 Go to the issue