Reference ranges (“normal values”) for cardiovascular magnetic resonance (CMR) in adults and children: 2020 update

Figures

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  Fig. 1. Contouring of the left ventricle (LV) and right ventricle (RV). Note that LV papillary muscle mass has been isolated and added to LV mass. RV papillary muscles and trabeculations were included in the RV volume

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  Fig. 2. Measurements of LV diameters obtained on cine bSSFP images during diastole (a, b) and systole (c, d) on the 4 chamber view (a, c) and short axis view (b, d). The longitudinal diameter of the LV was measured on the 4 chamber view as the distance between the mitral valve plane and the LV apex (a, c). On the 4 chamber view the transverse diameter was defined as the distance between the septum and the lateral wall at the basal level [18]. On the short axis view the transverse diameter was obtained at the level of the basal papillary muscles (b, d) [15]

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  Fig. 3. Measurement of left atrial area (A2Ch, A4Ch, A3C), longitudinal (L2Ch, L4Ch), transverse (T2Ch, T4Ch) and anteroposterior (APD) diameters on the 2-, 4- and 3-chamber views according to reference [31]

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  Fig. 4. Measurement of right atrial (RA) parameters according to [37]. Areas and diameters were measured in atrial diastole (maximal size of the left atrium) on the 2-chamber (top row) and 4-chamber (bottom row) views. In B), longitudinal diameter (L) is obtained from the posterior wall of the RA to the center of the tricuspid plane, and transverse diameter (T) is obtained perpendicular to the longitudinal diameter, at the mid level of the RA. C shows measurements of the area for both views including the RA appendage

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  Fig. 5. Reference curves for LV dimensions and function in children, reprinted with permission from reference [45]. Curves for boys are displayed in blue on the left, curves for girls are shown in pink on the right. Reference lines show the 3rd, 10th, 90th and 97th percentile. LV left ventricle, ED end diastolic, ES end systolic, SV stroke volume

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  Fig. 6. Reference curves for RV dimensions and function in children, reprinted with permission from reference [45]. Curves for boys are displayed in blue on the left, curves for girls are shown in pink on the right. Reference lines show the 3rd, 10th, 90th and 97th percentile. LV left ventricle, ED end diastolic, ES end systolic, SV stroke volume

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  Fig. 7. Example of measurement approaches for LV trabeculation. a End-diastolic thickness (in mm) of trabeculation according to the methodology in [56]: 3 slices representing base, mid and apex were selected from within the entire LV stack; trabeculated myocardial thickness was measured per slice; segment 17 excluded from analysis; authors do not clarify whether papillary muscles had been included or excluded from the trabecular measurement—in this reproduction we have excluded papillary muscles. b Maximal non-compacted (NC, red lines)/compacted (c, orange lines) wall thickness ratio according to the methodology in [61]: papillary muscles that were clearly observed as compact tubular structures were not included in the measurements; measurements in mm are shown in white and the maximal NC/C parameter highlighted in blue. c Trabeculation mass according to the methodology in [12]: the endocardial contour (red) was manually drawn; the trabecular contour (orange) was automatically segmented and papillary muscles (blue) that were included in the compact myocardial mass, were semi-automatically segmented; all slices of the LV short axis stack were analyzed. d Fractal dimension according to the…

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  Fig. 8. Images of a 4D flow sequence illustrating sites of measurement of peak systolic velocity. According to reference [77] measurements were obtained where the transvalvular velocity reaches its maximum during peak systole (vena contracta region) (a). In reference [76] peak systolic velocity was obtained in the ascending aorta 6 cm proximal from the most cranial point of the aortic arch centerline (b)

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  Fig. 9. Sites of measurement of the thoracic aorta. AS aortic sinus, STJ sinotubular junction, AA ascending aorta, BCA proximal to the origin of the brachiocephalic artery, T1 between the origin of the brachiocephalic artery and the left common carotid artery, T2 between the origin of the left common carotid artery and the left subclavian artery, IR isthmic region, DA descending aorta, D thoracoabdominal aorta at the level of the diaphragm

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  Fig. 10. Measurements of luminal diameters of the aortic annulus (a), the aortic sinus (b) and the sinotubular junction (c) obtained on a steady-state free precession left ventricular outflow tract view at diastole according to reference [86]

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  Fig. 11. Cusp-commissure (continuous lines) and cusp-cusp (dashed-lines) measurements at the level of the aortic sinus according to reference [85]

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  Fig. 12. Measurement of pulse wave velocity according to reference [92]. Δx: length of the centerline between the sites of flow measurement in the ascending and descending aorta; Δt: time delay between the flow curves obtained in the descending aorta relative to the flow curve obtained in the ascending aorta calculated between the midpoint of the systolic up slope tails on the flow versus time curves of the ascending aorta (ta1) and the descending aorta (ta2)