Abstract 3414: Assessment of Right Ventricular Volumes and Ejection Fraction by Real-Time 3-Dimensional Echocardiography in Children: A Validation Study Compared with Magnetic Resonance Imaging
Background: Assessment of right ventricular (RV) volumes and ejection fraction (EF) is crucial for a number of congenital heart diseases in children. However, measurement of these RV indexes by 2-dimensional echocardiography (2-DE) has limited accuracy and reproducibility because of the complex geometry of RV. The objective of this study was to validate real-time 3-dimensional echocardiography (RT 3-DE) for evaluation of RV volumes and RVEF in children by comparing with magnetic resonance imaging (MRI).
Methods: A total of 20 children (mean age 10.6 ± 2.8 years) were studied. Transthoracic RT 3-DE was performed using an RT 3-DE system (Philips Medical Systems) to acquire full-volume 3-DE datasets from apical windows. The images were processed offline using TomTec software package. RV end systolic volumes (ESV) and end diastolic volumes (EDV) were derived using a disk-summation method by manual tracing of the endocardial borders and RVEF calculated. For the study subjects, the MRI was performed on the same day as the RT 3-DE and the data were analyzed and measured using short axis slices from 2D SSFP cine MR images on an offline workstation.
Results: Of 20 children, 3 were excluded because of poor or incomplete RV images (2 RT 3-DE and 1 MRI studies). Among the 17 children, mean values of RV volumes and RVEF by RT 3-DE and MRI were: RVEDV (ml): 109.6 ± 36.2 vs. 116.7 ± 41.2; RVESV (ml): 45.1 ± 16.5 vs. 47.8 ± 19.8; RVSV (ml): 64.8 ± 25.3 vs. 68.9 ± 27.3; RVEF (%): 58.2 ± 8.5 vs. 58.6 ± 9.3. Good correlation and agreement between MRI and RT 3-DE were found (RVEDV: r = 0.98, p < 0.001, mean difference = − 7.0 ± 9.0, P < 0.01; RVESV: r = 0.96, p 0.05; RVEF: r = 0.89, p < 0.001, mean difference = − 0.3 ± 7.1, P > 0.05).
Conclusion: Measurement of RV volumes and EF by RT 3-DE is feasible and accurate in children and are comparable with MRI measurements.