Determination of the left ventricular long-axis orientation from a single short-axis MR image: relation to BMI and...

Accurate determination of imaging planes in relation to the left ventricular (LV) long-axis orientation is important for anatomical and functional evaluation as well as for serial comparisons with cardiac magnetic resonance (CMR) imaging. Therefore, a fast and reliable method to test the accuracy of CMR imaging for measuring the orientation of the LV long-axis was developed and validated. In addition, the relationship between LV long-axis orientation and body mass index (BMI), gender and age was assessed. Two approaches were used, a long-axis approach (based on a manually defined vector) and a short-axis approach (based on a calculated vector). The concordance between the two approaches was assessed in 72 healthy volunteers. The accuracy and precision of MR imaging for measuring three-dimensional orientations were tested using a LV phantom. The mean difference between the long- and short-axis approaches for measuring the LV long-axis orientation in the study population was 0 +/- 3 degrees, 0 +/- 2 degrees, and -1 +/- 3 degrees in the frontal, transverse and sagittal plane, respectively. BMI and age were shown to influence LV long-axis orientation, especially in the frontal and sagittal planes. A significant difference in LV long-axis orientation in the frontal and sagittal planes was found between genders. The correlation coefficient between MR-measured phantom orientation and true phantom orientation was >0.98 in all three orthogonal planes. These observations suggest that a single LV short-axis MR image can be used for measuring LV long-axis orientation in patients with no cardiac disease.