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Multicenter Study
. 2020 Jan 1;21(1):102-113.
doi: 10.1093/ehjci/jez164.

Multicentre reference values for cardiac magnetic resonance imaging derived ventricular size and function for children aged 0-18 years

J P G van der Ven  1   2 , Z Sadighy  1 , E R Valsangiacomo Buechel  3 , S Sarikouch  4 , D Robbers-Visser  5 , C J Kellenberger  6 , T Kaiser  3 , P Beerbaum  7 , E Boersma  8 , W A Helbing  1   9
Affiliations
Multicenter Study

Multicentre reference values for cardiac magnetic resonance imaging derived ventricular size and function for children aged 0-18 years

J P G van der Ven et al. Eur Heart J Cardiovasc Imaging. .

Erratum in

Abstract

Aims: Cardiovascular magnetic resonance (CMR) imaging is an important tool in the assessment of paediatric cardiac disease. Reported reference values of ventricular volumes and masses in the paediatric population are based on small cohorts and several methodologic differences between studies exist. We sought to create steady-state free precession (SSFP) CMR reference values for biventricular volumes and mass by combining data of previously published studies and re-analysing these data in a standardized manner.

Methods and results: A total of 141 healthy children (68 boys) from three European centres underwent cine-SSFP CMR imaging. Cardiac structures were manually contoured for end-diastolic and end-systolic phases in the short-axis orientation according to current standardized CMR post-processing guidelines. Volumes and masses were derived from these contours. Age-related reference curves were constructed using the lambda mu sigma method. Median age was 12.7 years (range 0.6-18.5). We report biventricular volumes and masses, unindexed and indexed for body surface area, stratified by age groups. In general, boys had approximately 15% higher biventricular volumes and masses compared with girls. Only in children aged <6 years old no gender differences could be observed. Left ventricle ejection fraction was slightly higher in boys in this study population (median 67% vs. 65%, P = 0.016). Age-related reference curves showed non-linear relations between age and cardiac parameters.

Conclusion: We report volumetric SSFP CMR imaging reference values for children aged 0-18 years old in a relatively large multi-centre cohort. These references can be used in the follow-up of paediatric cardiac disease and for research purposes.

Keywords: CMR imaging; MRI; congenital heart disease; paediatrics; reference values.

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Figures

Figure 1
Figure 1
Example of CMR segmentation. Contiguous slices are shown in end-systole and end-diastole for the same subject. The most apical slice in end diastole (slice 2) is not shown.
Figure 2
Figure 2
Sex and age distribution. Left (blue) shows the distribution of the boys and right (pink) shows the distribution of the girls.
Figure 3
Figure 3
Reference curves for the volumes and masses of the LV. Boys are displayed in the left column in blue and girls in the right column in pink. Left ventricle end diastolic (LVED), end systolic (LVES), and stroke volume (LVSV) and myocardial mass are presented. Reference lines show the 3rd, 10th, 50th, 90th, and 97th percentile.
Figure 4
Figure 4
Reference curves for the volumes and masses of the RV. Boys are displayed in the left column in blue and girls in the right column in pink. Right ventricle end diastolic (RVED), end systolic (RVES), and stroke volume (RVSV) and myocardial mass are presented. Reference lines show the 3rd, 10th, 50th, 90th, and 97th percentile.
Figure 5
Figure 5
Bland-Altman plots of inter-observer variability. Means and 95% confidence intervals are shown in dotted lines. These plots show no trend in variability with increasing mean volume or mass.LV, left ventricle; RV, right ventricle; EDV, end-diastolic volume.
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References

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