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[III-OR108-02] 閾値ベース磁気共鳴セグメンテーション・アルゴリズムによって定量化した肺右心室、体右心室及び単右心室の肉柱構造が機能と血流に及ぼす影響：正確な右室容量解析
Keywords:right ventricular trabeculation、cardiac magnetic resonance、threshold-based segmentation algorithm
Objective: To assess impacts of the right ventricular (RV) trabeculae and papillary muscles on measured function and blood flow in pulmonary, systemic and single right ventricle by cardiac magnetic resonance using threshold-based segmentation algorithm excludes these structures from the blood pool.
Method: We retrospectively examined three groups of patients. Those in group1 included pulmonary right ventricle (TOF), group2 included systemic right ventricle (ccTGA, dTGA following atrial switch procedure), and group3 included systemic single right ventricle (Fontan circulation). We measured RV myocardial mass (RV mass), end-diastolic and -systolic volume (RVEDV and RVESV) and stroke volume (RVSV). We also measured net pulmonary artery forward flow volume (PAFV) as RVSV in group1 and net ascending aorta forward flow volume (AoFV) as RVSV in group2 and 3 using phase contrast MR.
Results: There were 15 cases each of group and the mean age was 25+/-13 years. The systemic RV mass in group2 and 3 were more hypertrophied than pulmonary RV mass in group1 (p＜0.05). By excluding trabeculations in the RV blood volume, RVEDV, RVESV and RVSV in group2 and 3 were more decreased than it in group1 (p＜0.005). RVSV by PAFV in group1 and AoFV in group2 and 3 were more related (r=0.58 to 0.72) with value measured by segmentation algorithm rather than standard approach.
Conclusion: Excluding trabeculae and papillary muscle significantly affect measured pulmonary, systemic and single RV volumes. We highly recommended this novel method for measurement of true RV function and blood volume.
Method: We retrospectively examined three groups of patients. Those in group1 included pulmonary right ventricle (TOF), group2 included systemic right ventricle (ccTGA, dTGA following atrial switch procedure), and group3 included systemic single right ventricle (Fontan circulation). We measured RV myocardial mass (RV mass), end-diastolic and -systolic volume (RVEDV and RVESV) and stroke volume (RVSV). We also measured net pulmonary artery forward flow volume (PAFV) as RVSV in group1 and net ascending aorta forward flow volume (AoFV) as RVSV in group2 and 3 using phase contrast MR.
Results: There were 15 cases each of group and the mean age was 25+/-13 years. The systemic RV mass in group2 and 3 were more hypertrophied than pulmonary RV mass in group1 (p＜0.05). By excluding trabeculations in the RV blood volume, RVEDV, RVESV and RVSV in group2 and 3 were more decreased than it in group1 (p＜0.005). RVSV by PAFV in group1 and AoFV in group2 and 3 were more related (r=0.58 to 0.72) with value measured by segmentation algorithm rather than standard approach.
Conclusion: Excluding trabeculae and papillary muscle significantly affect measured pulmonary, systemic and single RV volumes. We highly recommended this novel method for measurement of true RV function and blood volume.