Anatomically Oriented Right Ventricular Volume Measurements With Dynamic Three-Dimensional Echocardiography Validated by 3-Tesla Magnetic Resonance Imaging
Petra S. Niemann, MD, PhD*,
Luiz Pinho, MD*,
Thomas Balbach, MD ,1,
Christian Galuschky, PhD,1,
Michael Blankenhagen, PhD,1,
Michael Silberbach, MD, FACC*,
Craig Broberg, MD, FACC*,
Michael Jerosch-Herold, PhD* and
David J. Sahn, MD, MACC*,2,*
* Oregon Health & Science University, Portland, Oregon
TomTec Imaging Systems, Unterschleissheim, Germany.
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Figure 1 Anatomical Right Ventricular Analysis
The right ventricular analysis program displays 3-dimensional ultrasound images in sagittal (top), 4-chamber (middle), and coronal (bottom) views in systole (left) and diastole (right), allowing manual tracing and adjustments in all planes.
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Figure 2 Analysis of Right Ventricular Magnetic Resonance Images
The magnetic resonance images are displayed similarly in sagittal (top), 4-chamber (middle), and coronal (bottom) views, in systole (left) and diastole (right) to allow manual tracing and adjustments in all planes.
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Figure 3 Workflow for Magnetic Resonance and 3D Echocardiography Images
Comparison of magnetic resonance imaging (MRI) (left) and 3-dimensional (3D) ultrasound (US) (right) tracing of the same patient with 4-dimensional right ventricular reconstruction (right). The MRI and 3D US analysis are both shown in the work flow for manual correction after contour detection.
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Figure 4 Regression Analysis and Agreement for RV Volumes by 3D Echo and MRI in All Subjects
Graphs show regression relationships and Bland-Altman plot comparisons of the 3D US and MRI method, regression analysis, and correlation coefficient in all 30 subjects for the right ventricular (RV) end-diastolic volume, RV end-systolic volume, RV stroke volume, and RV ejection fraction. Other abbreviations as in Figure 3.
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Figure 5 Agreement Statistics for the Separate Groups, Normal or Coronary Artery Disease Adults, and Children With Congenital Heart Disease
Graphs show Bland-Altman plots for both subgroups the Adult Coronary Artery Disease/Normal group and the Children Congenital Heart Disease group, comparing right ventricular (RV) end-diastolic volume (EDV), right ventricular end-systolic volume (ESV), right ventricular stroke volume (SV), and right ventricular ejection fraction (EF) obtained with MRI and 3D US. Abbreviations as in Figure 3.
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Figure 6 Bland-Altman Agreement for Stroke Volume
Graphs show a Bland-Altman comparison and correlation between MRI RV SV data obtained by phase-encoded velocity analysis and 3D US RV SV values from end-diastolic minus end-systolic computed RV volume. Abbreviations as in Figures 3 and 5.
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Figure 7 Bland-Altman Agreement Between Multiplanar 3D Echo Volumes and Simpson’s Rule MRI Data
Graphs show a Bland-Altman comparison with correlation coefficients between MRI RV EDV, ESV, SV, and EF data obtained by the standard Simpson summation method and 3D US RV EDV, ESV, SV, and EF data obtained by this novel RV analysis method. Abbreviations as in Figures 3 and 5.
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