Session SA1.4

Value of Regional and Global Right Ventricular Function Analysis Using Cardiac Magnetic Resonance Combined with Task Force Criteria for Diagnoses

A Azarine*, X Lyon, R Franck, A Redheuil,
A Ferreira, N Pasi, E Mousseaux

Hôpital Européen Georges Pompidou
Paris, France

To evaluate the value of segmental and global functions of the right ventricle (RV) in CMR as a single test or in combination with other Task Force (TF) criteria for ARVD/C. CMR was performed in 143 patients suspected of ARVD/C. Segmentation of the RV for wall motion analysis was established. The kinetics of each segment of the RV were independently assessed visually by two experienced operators, using different views, blinded to clinical data and results of the other imaging techniques. End-diastolic/systolic ventricular volumes were manually evaluated on short axis slices.
Results: Based on all exams, except CMR, 28 patients fulfilled criteria for ARVD/C according to the TF. Using CMR as a single test, the presence of major criteria alone/associated with minor criteria was 75%/93% sensitive and 94%/74% specific, the NPV being 94%/98%. Quantitative RV assessment did not improve diagnosis accuracy. Combining the other TF criteria with segmental RV kinetics minor & major criteria doesn't improve significantly the diagnostic accuracy being 89% sensitive with a NPV of 97%. Using the combination of clinical data with CMR as an alternative technique to other conventional cardiac imaging modalities changed the final diagnosis in 11%.
Conclusion: The presence of either major or minor anomalies of RV segmental kinetic has a good sensitivity and specificity. Normal segmental regional kinetic is a strong predictor for the absence of the disease. Still segmental analysis is not automated and requires experimented operators, thus, a new tool for automated segmentation and motion estimation/measurement of the RV wall from MRI images should help accurate diagnosis in all the imaging centers.

(Abstract Control Number: 270)