Society for Cardiovascular Magnetic Resonance reference values (“normal values”) in cardiovascular magnetic resonance: 2025 update

Figures

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

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  Fig. 2. Measurements of left ventricular diameters obtained on cine balanced steady-state free precession images during diastole (A, B) and systole (C, D) on the four-chamber view (A, C) and short-axis view (B, D). The longitudinal diameter of the left ventricle was measured on the four-chamber view as the distance between the mitral valve plane and left ventricular apex (A, C). On the four-chamber view, the transverse diameter was defined as the distance between the septum and the lateral wall at the basal level. On the short-axis view, the transverse diameter was obtained at the level of the basal papillary muscles (B, D)

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  Fig. 3. Measurements of left atrial area (A2C, A4C, A3C), longitudinal (L2C, L4C), and anteroposterior (APD) diameters on the two-, four-, and three-chamber view according to reference [38]

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  Fig. 4. Measurements of maximal left and right atrial volume using the Simpson’s method, obtained on a short-axis cine stack of balanced steady-state free precession images covering the atria, by contouring left (red) and right (blue) atrial borders at ventricular systole according to reference [11]

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  Fig. 5. Measurements of maximal right atrial areas (red), transverse diameters (blue), and longitudinal diameters (yellow) obtained on right ventricular two-chamber view (A) and four-chamber view (B) balanced steady-state free precession images at ventricular systole according to reference [47]. The longitudinal parameters (yellow) are obtained from the posterior wall of the right atrium to the center of the tricuspid plane and the transverse diameters (blue) are obtained perpendicular to the longitudinal parameter, at the mid level of the right atrium

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  Fig. 6. Example of measurement approaches for left ventricular trabeculation. (A) End-diastolic thickness (in mm) of trabeculation according to the methodology in [69]: three slices representing base, mid, and apex were selected from within the entire left ventricular 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 [71]: 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 [13]: 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 left ventricular short-axis…

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  Fig. 7. Image of a 4D flow sequence illustrating the site of measurement of peak systolic velocity at the vena contracta level according to reference [82]. 4D four-dimensional

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  Fig. 8. Measurements of mitral valve annulus diameter (red arrow) obtained on a four-chamber view (A), two-chamber view (B), and three-chamber view (C) and tricuspid valve annulus diameter (blue arrow) obtained on a four-chamber view (A) at diastole according to reference [83]

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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. Cusp-commissure (red lines) and cusp-cusp (blue lines) measurements at the level of the aortic sinus according to reference [95]

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  Fig. 11. Measurements of the diastolic diameters of the aortic annulus (red arrow), the aortic sinus (blue arrow), and the sinotubular junction (yellow arrow) on a left ventricular outflow tract view obtained with a balanced steady-state free precession sequence

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  Fig. 12. Measurement of aortic pulse wave velocity (PWV) according to reference [105]. Through plane flow-measurements at the level of the pulmonary trunk cutting across both the ascending and the proximal descending aorta, just below the diaphragm perpendicular to the descending aorta and just above the bifurcation of the abdominal aorta (A). Corresponding velocity encoded images (B). PWV is subsequently calculated from the distance along the aortic centerline between measurement locations (Δx) and the foot-to-foot transit time from the resulting velocity waveforms (Δt) (C).