Federico Sosa MD, Presenter: Nothing to Disclose

Hammed Abidemi Ninalowo MD, Abstract Co-Author: Nothing to Disclose

Jean Jeudy MD, Abstract Co-Author: Nothing to Disclose

Seth Jay Kligerman MD, Abstract Co-Author: Author, Amirsys, Inc Research Grant, Riverain Medical

Elizabeth Kristine Weihe MD, Abstract Co-Author: Nothing to Disclose

Glenn Steven Andrews MD, Abstract Co-Author: Nothing to Disclose

Charles S. White MD, Abstract Co-Author: Research Grant, Riverain Medical

The purpose of this study is to evaluate a fast and reliable method to evaluate the Right Ventricular Ejection Fraction (RVEF).

RV end-diastolic (RVEDV) and end-systolic volumes (RVESV) were measured in short-axis using a cine SSFP stack (8mm thick, 0mm gap) (Siemens Avanto 1.5T MRI). RVEF was quantified using Simpson’s method on Argus software (Siemens) and used as the gold standard. The predictive value of the following parameters were assessed based on this gold standard. Right ventricular end diastolic area (RVEDA), end systolic area (RVESA) and tricuspid annular plane systolic excursion (TAPSE) were measured on a 4-chamber view cine SSFP sequence performed at the mid-ventricular level. Fractional area change (FAC) was quantified as ((RVEDA-RVESA)/RVEDA). M-mode TAPSE was measured. The RVEF was independently assessed and qualitatively categorized as normal or as mild, moderate, or severe dysfunction. All measurements were performed by a fellowship trained cardiologist and cardiothoracic radiologist.

Eighty-eight patients were retrospectively assessed. Mean age was 53.2 ± 17.1 years. 68.2% (n=60) were males. RVEF was 50 ± 13.8 %. FAC was 44.3 ± 12.1 %. TAPSE was 1.89 ± 0.57 cm. M-mode TAPSE was 1.9 ± 0.55 cm. RVEF was qualitatively characterized as normal (70.5%) or with mild (14.8%), moderate (11.4%) or severe dysfunction (1.4%). FAC showed the best correlation with gold standard RVEF followed by TAPSE (r = 0.79, p ˂ 0.001; r = 0.6, p ˂ 0.001, respectively). FAC <38% predicted RVEF ≤45% with a sensitivity and specificity of 0.90 and 0.88, respectively (PPV = 0.95; NPV = 0.79). TAPSE ≤ 1.5 cm predicted RVEF ≤ 45% with a sensitivity and specificity of 0.92 and 0.73, respectively (PPV = 0.89; NPV = 0.79). M mode TAPSE ≤ 1.5 cm predicted RVEF ≤ 45% with a sensitivity and specificity of 0.92 and 0.69, respectively (PPV = 0.88; NPV = 0.78). The intra and interobserver agreement was high (Pearson Correlation = 0.91, and = 0.83, respectively).

A FAC ≤ 38% is an accurate and reliable method to predict a RVEF ≤ 45%.

Fractional Area Chabge can be a reliable method in the evaluation of the RV sistolic function.

Sosa, F, Ninalowo, H, Jeudy, J, Kligerman, S, Weihe, E, Andrews, G, White, C, Fractional Area Change: A Rapid, Reliable Method to Assess RVEF.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12036112.html