COMPARISON OF ECHOCARDIOGRAPHIC METHODS WITH MAGNETIC-RESONANCE-IMAGING FOR ASSESSMENT OF RIGHT-VENTRICULAR FUNCTION IN CHILDREN

Assessment of right ventricular (RV) Function is clinically relevant i n the follow-vp of various forms of congenital heart disease. Agreemen t on the value of different echocardiographic approaches for this purp ose is lacking. Magnetic resonance imaging (MRI) provides dimensionall y accurate RV volumes and election fraction. Transthoracic 2-dimension al echocardiography from 3 different views and gradient-echo tomograph ic MRI were performed in 16 children with congenital heart disease and 17 age-matched healthy children. RV volumes and election fraction wer e calculated with 5 mono- and biplane area-length and multiple-slice e chocardiographic methods. Adequate MRI and echocardiographic apical 4- chamber images could be obtained in all 33 children. The best correlat ion between MRI and echocardiographic volumes was with the biplane pyr amidal approximation method. End-diastolic volume by MRI was 92 +/- 27 ml: systematic difference with echocardiography was +14 +/- 16 ml (r = 0.86). End-systolic volume by MRI was 33 +/- 13 ml: systematic diffe rence with echocardiography was -4 +/- 7 ml (r = 0.82). Ejection fract ion by MRI was 65 +/- 8%: systematic difference with echocardiography was +5 +/- 7% (r = 0.72), using monoplane ellipsoid approximation. For all echocardiographic methods, significant effects of RV geometry wer e noted. Echocardiographic mono- and biplane area-length and multiple- slice calculations demonstrated moderate correlation and significant s ystematic errors compared with MRI-derived RV volumes. Echocardiograph ic results were influenced by RV geometry. The relatively simple monop lane area-length method provides ejection fraction results acceptable for clinical practice; results are not improved by more complex biplan e and/or multislice methods.