Circulation, Vol 84, 721-731, Copyright © 1991 by American Heart Association
WJ Rogers Jr, EP Shapiro, JL Weiss, MB Buchalter, FE Rademakers, ML Weisfeldt and EA Zerhouni
BACKGROUND. Measurement of regional left ventricular (LV) function is
predicted on the ability to compare equivalent LV segments at different
time points during the cardiac cycle. Standard techniques of short-axis
acquisition in two-dimensional echocardiography, cine computed tomography,
and standard magnetic resonance imaging (MRI) acquire images from a fixed
plane and fail to compensate for through-plane motion. The shortening of
the left ventricle along its long axis during systole results in planar
images of two different levels of the ventricle, leading to error in any
derived functional measurements. LV systolic long-axis motion was measured
in 19 normal volunteers using MRI. METHODS AND RESULTS. With a selective
radio frequency (RF) tissue- tagging technique, three short-axis planes
were labeled at end diastole and standard spin-echo images were acquired at
end systole in the two- and four-chamber orientations. Persistence of the
tags through systole allowed visualization of the intersecting short-axis
tags in the long- axis images and allowed precise quantification of
long-axis motion of the septum, lateral, anterior, and inferior walls at
the base, mid, and apical LV levels. The total change in position along the
long axis between end diastole and end systole was greatest at the base,
which moved toward the apex 12.8 +/- 3.8 mm. The mid left ventricle moved
6.9 +/- 2.6 mm, and the apex was nearly stationary, moving only 1.6 +/- 2.2
mm (p less than 0.001). Having quantified the normal range of long-axis
shortening, we developed a technique that isolates a slice of tissue
between selective RF saturation planes at end diastole. Combining this with
a wide end-systolic image slice, end-systolic images were acquired without
contamination of signal from adjacent tissue moving into the imaging plane.
This technique was validated in a moving phantom and in normal volunteers.
CONCLUSIONS. Significant LV systolic long-axis shortening exists, and this
effect is seen the most at the base and the least at the apex. At a given
ventricular level, shortening varied significantly according to location. A
method using selective saturation pulses and gated spin-echo MRI
automatically corrects for this motion and thus eliminates misregistration
artifact from regional function analysis.
ARTICLES
Quantification of and correction for left ventricular systolic long- axis shortening by magnetic resonance tissue tagging and slice isolation
Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, Md.
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