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MR Imaging of the Heart in Patients after Myocardial Infarction: Effect of Increasing Intersection Gap on Measurements of Left Ventricular Volume, Ejection Fraction, and Wall Thickness¹

¹ From the Departments of Cardiology (Y.C., P.L., J.E.W.) and Magnetic Resonance Imaging (C.T., F.G., A.L., O.R., S.R., P.M.W., F.B.), Centre Hospitalier Universitaire, 10, Boulevard Maréchal de Lattre de Tassigny, 21034 Dijon, France. Received July 27, 1998; revision requested October 14; revision received January 6, 1999; accepted March 26. Address reprint requests to Y.C. (e-mail: ctouzery@dijon.fnclcc.fr).

View larger version (208K): [in a new window]   Figure 1. Coronal MR image of the phantom obtained by using a two-dimensional fast low-angle shot sequence: 9/4.8, a flip angle of 15°, nine lines per segment, a field of view of 300 mm, an acquisition matrix of 144 x 256, and a section thickness of 5 mm.

View larger version (18K): [in a new window]   Figure 2. Diagram shows methods of determining the left ventricular volume. a, Left ventricular volume determined by using the contiguous short-axis section set SAng; A1,A2,A3,. . .,An indicates the area of ventricular cavity measured on the first, second, third,. . .,nth section. I = intersection gap. Left ventricular volume (V) was calculated according to the following equation: V = Ai x I. b, Left ventricular volume determined by using the modified Simpson rule model. Am = area of the left ventricular cavity measured on the short-axis section at the mitral valve level, Ap = area of the left ventricular cavity measured on the short-axis section at the level of the papillary muscle, L = length of the left ventricular long axis. Left ventricular volume (V) was calculated according to the following equation: V = [Am + (Am + Ap)/2 + Ap/3] x L/3. c, Left ventricular volume determined by using the hemisphere-cylinder model. Am = area of the left ventricular cavity measured on the short-axis section at the mitral valve level, L = length of the left ventricular long axis. Left ventricular volume (V) was calculated according to the following equation: V = (Am + 2 x Am/3) x L/2. d, Left ventricular volume determined by using the biplane ellipsoid model. A1 = area of the left ventricular cavity measured on the vertical long-axis section, A2 = area of the left ventricular cavity measured on the horizontal long-axis section, L = length of the left ventricular long axis. Left ventricular volume (V) was calculated according to the following equation: V = 8 x A1 x A2/(3L). e, Left ventricular volume determined by using either the horizontal long-axis plane ellipsoid model or the vertical long-axis plane ellipsoid model. A1 = area of the left ventricular cavity measured on the vertical long-axis section or the horizontal long-axis section, L = length of the left ventricular long axis. Left ventricular volume (V) was calculated according to the following equation: V = 8 x A12/(3L). f, Left ventricular volume determined by using the Teicholz model. D = diameter of the left ventricular cavity measured on the short-axis section at the mitral valve level. Left ventricular volume (V) was calculated according to the following equation: V = 7 x D3/(2.4 + D).

View larger version (13K): [in a new window]   Figure 3. Bland-Altman plots of ejection fraction (EF) calculated by means of the SA5mm (SA[5]; left) and SA10mm (SA[10]; middle) intersection gap methods and the modified Simpson rule model (MSR; right) versus the contiguous-section method (SA[0]). The difference between each pair of either SA5mm, SA10mm, or modified Simpson rule model and SAng methods is plotted against the average value of the same pair. Individual ejection fraction differences are illustrated by triangles. Mean (M) differences and mean ± 2 SD limits are represented by solid lines.

View larger version (16K): [in a new window]   Figure 4a. (a) Bland-Altman plots of end-diastolic (DWT; left) or end-systolic (SWT; middle) wall thicknesses or absolute wall thickening (AWT; right) calculated by means of the SA5mm intersection gap method (SA[5]) versus the contiguous-section method (SA[0]). The difference between each pair of SA5mm and SAng methods is plotted against the average value of the same pair. Individual differences are illustrated by triangles. Mean (M) differences and mean ± 2 SD limits are represented by solid lines. (b) Bland-Altman plots of end-diastolic (DWT; left) or end-systolic (SWT; middle) wall thicknesses or absolute wall thickening (AWT; right) calculated by means of the SA10mm intersection gap method (SA[10]) versus the contiguous-section method (SA[0]). The difference between each pair of SA10mm and SAng methods is plotted against the average value of the same pair. Individual differences are illustrated by triangles. Mean (M) differences and mean ± 2 SD limits are represented by solid lines.

View larger version (17K): [in a new window]   Figure 4b. (a) Bland-Altman plots of end-diastolic (DWT; left) or end-systolic (SWT; middle) wall thicknesses or absolute wall thickening (AWT; right) calculated by means of the SA5mm intersection gap method (SA[5]) versus the contiguous-section method (SA[0]). The difference between each pair of SA5mm and SAng methods is plotted against the average value of the same pair. Individual differences are illustrated by triangles. Mean (M) differences and mean ± 2 SD limits are represented by solid lines. (b) Bland-Altman plots of end-diastolic (DWT; left) or end-systolic (SWT; middle) wall thicknesses or absolute wall thickening (AWT; right) calculated by means of the SA10mm intersection gap method (SA[10]) versus the contiguous-section method (SA[0]). The difference between each pair of SA10mm and SAng methods is plotted against the average value of the same pair. Individual differences are illustrated by triangles. Mean (M) differences and mean ± 2 SD limits are represented by solid lines.