Horizontal Long Axis Imaging Plane for Evaluation of Right Ventricular Function on Cardiac Magnetic Resonance Imaging

Figures

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  Figure 1. Limitations of the short-axis orientation for right ventricular functional analysis. Short axis (b and d) and horizontal long axis (a and c) balanced steady-state free precession cardiac magnetic resonance images of the heart: diastole (a and b) and systole (c and d). The straight line on the horizontal long axis images (a and c) depicts the location of the corresponding basilar short-axis image in diastole (c) and at the same location with the ventricle in systole (d). Example illustrates the apical displacement of the tricuspid valve plane with systole (d) and the thin wall of the right ventricle that can be difficult to distinguish from the right atrium on the short-axis orientation (b and d).

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  Figure 2. Acquiring the right horizontal long axis cine stack. A stack of parallel cine balanced steady-state free precession images (straight lines) is aligned parallel to the horizontal long axis of the right ventricle on the right ventricle long axis (a) and sagittal right ventricle outflow tract (b) images, which allow determination of the level of the pulmonic valve and the obliquity of the inferior wall of the right ventricle.

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  Figure 3. Right horizontal long-axis cine stack obtained from the right ventricle long axis and right ventricle outflow tract. It extends from above the pulmonic valve to below the inferior border of the right ventricle.

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  Figure 4. Bland–Altman plots of the mean difference between methods for (a) end-diastolic volume, reviewer 1, (b) end-diastolic volume, reviewer 2, (c) end-systolic volume, reviewer 1, (d) end-systolic volume, reviewer 2, (e) ejection fraction, reviewer 1, and (f) ejection fraction, reviewer 2. Dotted lines represent the mean difference for each right ventricle functional measurement, and dashed lines depict the upper and lower limits of agreement.

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  Figure 5. Bland–Altman plots of the mean difference between reviewers (a) end-diastolic volume, right horizontal long axis, (b) end-diastolic volume, short axis, (c) end-systolic volume, right horizontal long axis, (d) end-systolic volume, short axis, (e) ejection fraction, right horizontal long axis, and (f) ejection fraction, short axis. Dotted lines represent the mean difference for each right ventricle functional measurement, and dashed lines depict the upper and lower limits of agreement.