CMR Unit, Royal Brompton Hospital, London, UK.
National Heart and Lung Institute, Imperial College, London, UK.
J Cardiovasc Magn Reson. 2021 Jan 4;23(1):1. doi: 10.1186/s12968-020-00692-2.
Pediatric patients are becoming increasingly referred for cardiovascular magnetic resonance (CMR). Measurement of ventricular wall thickness is typically part of the assessment and can be of diagnostic importance, e.g. in arterial hypertension. However, normal values for left ventricular (LV) and right ventricular (RV) wall thickness in pediatric patients are lacking. The aim of this study was to establish pediatric centile charts for segmental LV and RV myocardial thickness in a retrospective multicenter CMR study.
CMR was performed in 161 healthy children and adolescents with an age range between 6 and 18 years from two centers in the UK and Germany as well as from a previously published CMR project of the German Competence Network for Congenital Heart Defects. LV myocardial thickness of 16 segments was measured on the short axis stack using the American Heart Association segmentation model. In addition, the thickness of the RV inferior and anterior free wall as well as biventricular mass was measured.
The mean age (standard deviation) of the subjects was 13.6 (2.9) years, 64 (39.7%) were female. Myocardial thickness of the basal septum (basal antero- and inferoseptal wall) was 5.2 (1.1) mm, and the basal lateral wall (basal antero- and inferolateral) measured 5.1 (1.2) mm. Mid-ventricular septum (antero- and inferoseptal wall) measured 5.5 (1.2) mm, and mid-ventricular lateral wall (antero- and inferolateral wall) was 4.7 (1.2) mm. Separate centile charts for boys and girls for all myocardial segments and myocardial mass were created because gender was significantly correlated with LV myocardial thickness (p < 0.001 at basal level, p = 0.001 at midventricular level and p = 0.005 at the apex) and biventricular mass (LV, p < 0.001; RV, p < 0.001).
We established CMR normal values of segmental myocardial thickness and biventricular mass in children and adolescents. Our data are of use for the detection of abnormal myocardial properties and can serve as a reference in future studies and clinical practice.
儿科患者越来越多地接受心血管磁共振(CMR)检查。心室壁厚度的测量通常是评估的一部分,并且具有诊断意义,例如在动脉高血压中。然而,儿科患者的左心室(LV)和右心室(RV)壁厚度的正常值尚不清楚。本研究的目的是在回顾性多中心 CMR 研究中建立儿科分段 LV 和 RV 心肌厚度的百分位图表。
在英国和德国的两个中心以及德国先天性心脏病能力网络的先前发表的 CMR 项目中,对年龄在 6 至 18 岁之间的 161 名健康儿童和青少年进行了 CMR 检查。使用美国心脏协会分段模型测量短轴堆栈中的 16 个节段的 LV 心肌厚度。此外,还测量了 RV 下壁和前壁的厚度以及双心室质量。
受试者的平均年龄(标准差)为 13.6(2.9)岁,64 人(39.7%)为女性。基底隔(基底前壁和下壁)的心肌厚度为 5.2(1.1)mm,基底外侧壁(基底前外侧壁和下外侧壁)为 5.1(1.2)mm。中室间隔(前壁和下壁)为 5.5(1.2)mm,中室间隔外侧壁(前壁和外侧壁)为 4.7(1.2)mm。由于性别与 LV 心肌厚度显著相关(基底水平 p<0.001,中室水平 p=0.001,心尖水平 p=0.005)和双心室质量(LV,p<0.001;RV,p<0.001),因此为所有心肌节段和心肌质量创建了男孩和女孩的单独百分位图表。
我们建立了儿童和青少年分段心肌厚度和双心室质量的 CMR 正常值。我们的数据可用于检测异常心肌特性,并可在未来的研究和临床实践中作为参考。