Right ventricular function by MRI

Abstract

Purpose of review: For years, the right ventricle (RV) has been deemed 'unnecessary', as shown by procedures such as Fontan surgery. More recently, right ventricular dysfunction has been recognized as a prognostic factor in many cardiovascular diseases. Supported by advances in echocardiography and MRI, assessment of right ventricular function and morphology has gained interest. The goal of this review is to offer a current clinical perspective on right ventricular function as assessed by MRI.

Recent findings: MRI has progressed towards a fast and reliable technique for assessing right ventricular morphology, volumes and function. Strain-encoded techniques and single breath-hold four-dimensional acquisition techniques are promising, but need to be confirmed in patient studies. Continuous improvement in postprocessing software has further reduced analysis time and effort.

Summary: Our understanding of right ventricular behavior even in complex heart disease has taken substantial benefit from modern cardiac MRI techniques. MRI imaging of the RV is patient-tailored, integrating right ventricular volumetric and functional analysis in a comprehensive approach, including assessment of cardiac morphology, myocardial tissue characteristics, flow patterns and great vessel anatomy. This approach provides the clinician a complete view, not only of the RV as such, but also of the RV being an essential part of the cardiopulmonary system.