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Cardiovascular magnetic resonance normal values in children for biventricular wall thickness and mass
Sylvia Krupickova1,2, Julian Risch3, Sabiha Gati1
1CMR Unit, Royal Brompton Hospital, London, UK.
Insights
This study establishes normal cardiovascular magnetic resonance (CMR) values for ventricular wall thickness in pediatric patients. These findings provide essential reference data for diagnosing conditions like arterial hypertension in children.
Area of Science:
- Cardiology
- Pediatric Imaging
- Biomedical Engineering
Background:
- Increasing referrals for pediatric cardiovascular magnetic resonance (CMR) necessitate established normal values for ventricular wall thickness.
- Ventricular wall thickness is crucial for diagnosing conditions such as arterial hypertension in pediatric patients.
- Current pediatric reference values for left ventricular (LV) and right ventricular (RV) wall thickness are lacking.
Purpose of the Study:
- To establish pediatric centile charts for segmental LV and RV myocardial thickness.
- To provide normal values for myocardial thickness and biventricular mass in healthy children and adolescents using CMR.
- To create a reference standard for clinical practice and future research in pediatric cardiology.
Main Methods:
- Retrospective multicenter study involving 161 healthy children and adolescents (6-18 years).
- Cardiovascular magnetic resonance (CMR) imaging was performed, with LV myocardial thickness measured across 16 segments.
- RV free wall thickness and biventricular mass were also assessed using the American Heart Association segmentation model.
Main Results:
- Established normal values for segmental myocardial thickness and biventricular mass in pediatric subjects.
- Found significant correlations between gender and LV myocardial thickness, as well as biventricular mass, necessitating gender-specific centile charts.
- Provided specific measurements for basal and mid-ventricular septal and lateral walls.
Conclusions:
- Successfully established CMR-derived normal values for segmental myocardial thickness and biventricular mass in children and adolescents.
- The generated data serve as a valuable reference for detecting abnormal myocardial properties.
- These findings will aid in future pediatric cardiovascular studies and clinical practice.
Background:
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.
Methods:
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.
Results:
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).
Conclusion:
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.
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