Evaluation of left ventricular aneurysms before and after surgery using Cine-MR1.

To demonstrate the usefulness of cine-MRI for the evaluation of apical left ventricular aneurysms (ALVA) and for prediction of the surgical outcome. M aterials and Methods: We investigated 28 patients with ALVA, 13 of them add itionally after aneurysmectomy at 1.5 T; 15 healthy volunteers served as no rmal controls. For cine-MRI k-space segmented FI-2D-GE sequences were used. Analysis comprised the calculation of cardiac volume indices, cardiac func tion, and percentual myocardial thickening (PMT). For prediction of surgica l results we divided left ventricle into an aneurysmatic and a non-aneurysm atic part. The non-aneurysmatic part was assumed as the left ventricle afte r surgical remodelling. Results: Enddiastolic and endsystolic volume indice s (EDVIs and LV-ESVIs) were higher in patients with ALVA (123.7 +/- 30.2 ml /m(2), 94.3 +/- 32.5 ml/m(2), respectively) than in volunteers (79.1 +/- 13 .9 ml/m(2), 25.5 +/- 5.1 ml/m(2), respectively) (p < 0.001). Stroke volume index (SVIs), cardiac index (Cis) and ejection fraction (EFs) were signific antly lower in patients (30.4 +/- 9.1 vs. 54.2 +/- 0.2 ml/beat/m(2); 2.2 +/ - 0.8 vs. 3.9 +/- 0.9 l/ min/m(2), 26.0 +/- 9.7 vs. 67.9 +/- 4.5%, respecti vely) (p < 0.001). There was a significant decrease of LV-EDVIs and LV-ESVI s (102.8 +/- 30.3 ml/m(2), 66.3 +/- 28.0 ml/m(2), respectively) (p = 0,002, p < 0.001, respectively), no change of SVIs (36.4 +/- 6.0 ml/beat/m(2)) (p > 0.05) and a significant increase of Cis and EFs (3.0 +/- 0.6 l/min/m(2), 37.91 +/- 10.15%, respectively) (p < 0.001) after surgery. We found a good correlation between the preoperatively calculated (32.6 +/- 10.1 %) and th e measured EF after surgery (37.9 +/- 9.8 %) (r = 0.70; p = 0.035). PMT was significantly lower in patients than in volunteers (median 11.9 +/- 10.7 v s. 70.2 13.9 %; p < 0.001). especially in the aneurysmatic parts of left ve ntricle (median -6.8 %; p < 0.001). Conclusion: Cine-MRI offers accurate ev aluation of ALVA and enables preoperative estimation of left-ventricular vo lumes after surgery.