A novel technique using biplane cine magnetic resonance imaging to evaluate left ventricular volume in children

The purpose of the study is to determine the feasibility of a novel simplified technique using cine magnetic resonance imaging (MRI) to assess left ventricular (LV) volume and ejection fraction (EF) validated by comparison with biplane LV angiography. Previous MRI studies to assess LV volumes have used multiple axial planes, which are compromised by partial volume effects and are time consuming to acquire and analyze. Accordingly, we developed a simplified imaging approach using biplane cine MRI and imaging planes aligned with the intrinsic cardiac axes of the LV. We studied 20 children (aged 4 months to 10 years) with various heart diseases. The accuracy of cine MRI was compared with that of LV angiography in all patients. LV volumes were calculated using Simpson's rule algorithm, for both MRI and LV angiography. LV volumes determined from MRI were slightly underestimated but correlated reasonably well with angiographic volumes (LVEDV: Y = 0.88X + 1.58, r = 0.99, LVESV: Y = 0.73X + 1.03, r = 0.98). Most importantly, even in patients who had abnormal ventricular curvature such as in tetralogy of Fallot, MRI determined LV volumes correlated well with angiographic values. The MR study was completed within 35 min in all patients. In conclusion, simplified biplane cine MRI, using the intrinsic LV axis planes, permits noninvasive assessment of LV volumes in views comparable to standard angiographic projections and appears practical for clinical use in childhood heart disease since the scan and analysis times are relatively short.