Right ventricular end-systolic area as a simple first-line marker predicting right ventricular enlargement and decreased systolic function in children referred for cardiac magnetic resonance imaging. Issue 6 (June 2018)

• Record Type: Journal Article
• Authors: Barczuk-Falęcka, M.; Małek, Ł.A.; Roik, D.; Werys, K.; Werner, B.; Brzewski, M.
• Is Part Of: Clinical radiology. Volume 73:Issue 6(2018)
• Page Start: 592.e9
• Page End: 592.e14
• Publication Date: 2018-06
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2018.01.020
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : Aim: To assess the accuracy of simple cardiovascular magnetic resonance imaging (CMR) parameters for first-line analysis of right ventricle (RV) dysfunction in children to identify those who require in-depth analysis and those in whom simple assessment is sufficient. Materials and methods: Sixty paediatric CMR studies were analysed. The following CMR parameters were measured: RV end-diastolic and end-systolic area (4CH EDA and 4CH ESA), fractional area change (FAC), RV diameter in end-diastole (RVD1), tricuspid annular plane systolic excursion (TAPSE), and RV outflow tract diameter in end-diastole (RVOT prox). They were correlated with RV end-diastolic volume (RVEDVI) and RV ejection fraction (RVEF). Results: RVEDVI correlated best with 4CH ESA ( r =0.85, <0.001) and EDA ( r =0.82, <0.001). For RVEF only a moderate reverse correlation was found for 4CH ESA (–0.56, <0.001), 4CH EDA (–0.49, 0.001) and positive correlation for FAC (0.49, <0.001). There was no correlation between TAPSE and RVEF and only weak between RVD1 and RVEDVI. A 4CH ESA cut-off value of 8.5 cm 2 /m 2 had a very high diagnostic accuracy for predicting an enlarged RV (AUC = 0.912, p <0.001, sensitivity 92.3%, specificity 79%) and a cut-off value of 10.5 cm 2 /m 2 was also a good predictor of depressed RV systolic function (AUC = 0.873, p <0.001, sensitivity 83%, specificity 89%). Conclusion: For routine screening in clinical practice, 4CH ESA seems a reliable and easy method to identify patients with RV dysfunction. Highlights: Cardiac magnetic resonance is a gold standard in right ventricle (RV) assessment. RV assessment is a time-consuming analysis in routine clinical studies. Screening of RV size and function in children is possible with simple parameters. RV end-systolic area > 8.5 cm2/m2 can be a first-line indicator of RV pathology. RV diameter in 4CH and TAPSE are of limited use as screening tools in children.