Department of Radiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Int J Cardiovasc Imaging. 2013 Mar;29(3):625-31. doi: 10.1007/s10554-012-0112-7. Epub 2012 Sep 4.
The objective of this study was to assess the impact of right ventricular (RV) trabeculae and papillary muscles on measured volumes and function assessed by cardiovascular magnetic resonance imaging in patients with repaired tetralogy of Fallot. Sixty-five patients with repaired tetralogy of Fallot underwent routine cardiovascular magnetic resonance imaging. Endocardial and epicardial contours were drawn manually and included trabeculae and papillary muscles in the blood volume. Semi-automatic threshold-based segmentation software excluded these structures. Both methods were compared in terms of end-diastolic, end-systolic and stroke volume, ejection fraction and mass. Observer agreement was determined for all measures. Exclusion of trabeculae and papillary muscle in the RV blood volume decreased measured RV end-diastolic volume by 15 % (from 140 ± 35 to 120 ± 32 ml/m(2)) compared to inclusion, end-systolic volume by 21 % (from 74 ± 23 to 59 ± 20 ml/m(2)), stroke volume by 9 % (from 66 ± 16 to 60 ± 16 ml/m(2)) and relatively increased ejection fraction by 7 % (from 48 ± 7 to 51 ± 8 %) and end-diastolic mass by 79 % (from 28 ± 7 to 51 ± 10 g/m(2)), p < .01. Excluding trabeculae and papillary muscle resulted in an improved interobserver agreement of RV mass compared to including these structures (coefficient of agreement of 87 versus 78 %, p < .01). Trabeculae and papillary muscle significantly affect measured RV volumes, function and mass. Semi-automatic threshold-based segmentation software can reliably exclude trabeculae and papillary muscles from the RV blood volume.
这项研究的目的是评估右心室（RV）小梁和乳头肌对修复法洛四联症患者心血管磁共振成像测量容积和功能的影响。65 例修复后的法洛四联症患者接受了常规心血管磁共振成像检查。心内膜和心外膜轮廓手动绘制，并包括小梁和乳头肌的血容量。半自动基于阈值的分割软件排除了这些结构。比较了两种方法在舒张末期、收缩末期和stroke volume、射血分数和质量方面的差异。对所有指标的观察者间一致性进行了测定。排除 RV 血容量中的小梁和乳头肌，使测量的 RV 舒张末期容积减少 15%（从 140±35ml/m2 降至 120±32ml/m2），收缩末期容积减少 21%（从 74±23ml/m2 降至 59±20ml/m2），stroke volume 减少 9%（从 66±16ml/m2 降至 60±16ml/m2），射血分数相对增加 7%（从 48±7%升至 51±8%），舒张末期质量增加 79%（从 28±7g/m2 增至 51±10g/m2），p<0.01。与包括这些结构相比，排除小梁和乳头肌可显著提高 RV 质量的观察者间一致性（一致性系数为 87 对 78%，p<0.01）。小梁和乳头肌对测量的 RV 容积、功能和质量有显著影响。半自动基于阈值的分割软件可以可靠地将小梁和乳头肌从 RV 血容量中排除。
