Normal values for cardiovascular magnetic resonance in adults and children

Abstract

Morphological and functional parameters such as chamber size and function, aortic diameters and distensibility, flow and T1 and T2* relaxation time can be assessed and quantified by cardiovascular magnetic resonance (CMR). Knowledge of normal values for quantitative CMR is crucial to interpretation of results and to distinguish normal from disease. In this review, we present normal reference values for morphological and functional CMR parameters of the cardiovascular system based on the peer-reviewed literature and current CMR techniques and sequences.

Figure 1

LV contouring. Note that LV papillary muscle mass has been isolated and added to left ventricular mass.

Figure 2

Left ventricular volumes, mass and function in systole and diastole normalized to age and body surface area for males according to reference [ 5 ].

Figure 3

Left ventricular volumes, mass and function in systole and diastole normalized to age and body surface area for females according to reference [ 5 ].

Figure 4

Example of RV contouring using a semiautomatic software. Note that papillary muscles were included in RV mass (arrow).

Figure 5

Right ventricular volumes, mass and function for males by age decile.

Figure 6

Right ventricular volumes, mass and function for females by age decile.

Figure 7

Example of contouring for the biplane area-length method from reference [ 4 ]. The left atrial appendage was included in the atrial volume and the pulmonary veins were excluded.

Figure 8

Contouring of the left and right atrium using a 3D modeling method according to reference [ 17 ].

Figure 9

Measurement of left atrial area (A2C, A4C, A3C), longitudinal (L2C, L4C), transverse (T2C, T4C) and anteroposterior (APD) diameters on the 2-, 4- and 3-chamber views according to reference [ 17 ].

Figure 10

Percentiles for left ventricular parameters in children according to reference [ 25 ].

Figure 11

Percentiles for left ventricular papillary muscle mass in children according to reference [ 25 ].

Figure 12

Percentiles for right ventricular parameters in children according to reference [ 25 ].

Figure 13

The anatomic locations of aorta measurements: A. aortic valve annulus; B. aortic sinus; C. sinotubular junction; D. ascending aorta and proximal descending aorta; E. abdominal aorta.

Figure 14

Cusp-commissure (continuous lines) and cusp-cusp (dashed-lines) measurements at the level of the aortic sinus.

Figure 15

Sites of measurement. AS = aortic sinus; STJ = sinotubular junction; AA = ascending aorta; BCA = proximal to the origin of the brachiocephalic artery; T1 = first transverse segment; T2 = second transverse segment; IR = isthmic region; DA = descending aorta; D = thoracoabdominal aorta at the level of the diaphragm.

Figure 16

Reference percentiles for aortic areas measured at four different sites (ascending aorta [a], aortic arch [b], aortic isthmus [c] and descending aorta above the diaphragm [d]) on cine GRE images at maximal aortic distension according to reference [ 53 ].

Figure 17

Measurement of pulse wave velocity according to reference [ 53 ] . Δx = length of the centerline between the sites of flow measurement in the ascending and descending aorta (A); Δt = time delay between the flow curves obtained in the descending aorta relative to the flow curve obtained in the ascending aorta calculated between the midpoint of the systolic up slope tails on the flow versus time curves of the ascending aorta (ta1) and the descending aorta (ta2) (B).

Figure 18

Reference percentiles for aortic distensibility measured at four different sites (ascending aorta [a], aortic arch [b], aortic isthmus [c] and descending aorta above the diaphragm [d]) on cine GRE images at maximal aortic distension according to reference [ 53 ].

Figure 19

Reference percentiles for aortic pulse wave velocity according to reference [ 53 ].

Figure 20

T1 maps pre- and post-contrast with left ventricular endocardial and epicardial contours.

Figure 21

Measurements for myocardial T2* are obtained in the septum.