Revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis

Abstract Background Accurate measurement of left atrial (LA) volumes is needed in cardiac diagnostics and the follow up of heart and valvular diseases. Geometrical assumptions with 2D methods for LA volume estimation contribute to volume misestimation. In this study, we test agreement of 3D and 2D m...

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Autores principales:	Jouni K. Kuusisto, Pauli A. K. Pöyhönen, Jani Pirinen, Lauri J. Lehmonen, Heli P. Räty, Nicolas Martinez-Majander, Jukka Putaala, Juha Sinisalo, Vesa Järvinen
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Left atrium Volume assessment Shape Axis Cardiac magnetic resonance imaging Sphericity Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/635923c3bac14fe286a8b7054d77bfd5
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spelling	oai:doaj.org-article:635923c3bac14fe286a8b7054d77bfd52021-11-14T12:33:34ZRevisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis10.1186/s12880-021-00701-51471-2342https://doaj.org/article/635923c3bac14fe286a8b7054d77bfd52021-11-01T00:00:00Zhttps://doi.org/10.1186/s12880-021-00701-5https://doaj.org/toc/1471-2342Abstract Background Accurate measurement of left atrial (LA) volumes is needed in cardiac diagnostics and the follow up of heart and valvular diseases. Geometrical assumptions with 2D methods for LA volume estimation contribute to volume misestimation. In this study, we test agreement of 3D and 2D methods of LA volume detection and explore contribution of 3D LA axis orientation and LA shape in introducing error in 2D methods by cardiovascular magnetic resonance imaging. Methods 30 patients with prior first-ever ischemic stroke and no known heart disease, and 30 healthy controls were enrolled (age 18–49) in a substudy of a prospective case–control study. All study subjects underwent cardiac magnetic resonance imaging and were pooled for this methodological study. LA volumes were calculated by biplane area-length method from both conventional long axis (LAVAL-LV) and LA long axis-oriented images (LAVAL-LA) and were compared to 3D segmented LA volume (LAVSAX) to assess accuracy of volume detection. 3D orientation of LA long axis to left ventricular (LV) long axis and to four-chamber plane were determined, and LA 3D sphericity indices were calculated to assess sources of error in LA volume calculation. Shapiro–Wilk test, Bland–Altman analysis, intraclass and Pearson correlation, and Spearman’s rho were used for statistical analysis. Results Biases were − 9.9 mL (− 12.5 to − 7.2) for LAVAL-LV and 13.4 (10.0–16.9) for LAVAL-LA [mean difference to LAVSAX (95% confidence interval)]. End-diastolic LA long axis 3D deviation angle to LV long axis was 28.3 ± 6.2° [mean ± SD] and LA long axis 3D rotation angle to four-chamber plane 20.5 ± 18.0°. 3D orientation of LA axis or 3D sphericity were not correlated to error in LA volume calculation. Conclusions Calculated LA volume accuracy did not improve by using LA long axis-oriented images for volume calculation in comparison to conventional method. We present novel data on LA axis orientation and a novel metric of LA sphericity and conclude that these measures cannot be utilized to assess error in LA volume calculation. Trial registration Main study Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725) has been registered previously.Jouni K. KuusistoPauli A. K. PöyhönenJani PirinenLauri J. LehmonenHeli P. RätyNicolas Martinez-MajanderJukka PutaalaJuha SinisaloVesa JärvinenBMCarticleLeft atriumVolume assessmentShapeAxisCardiac magnetic resonance imagingSphericityMedical technologyR855-855.5ENBMC Medical Imaging, Vol 21, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Left atrium Volume assessment Shape Axis Cardiac magnetic resonance imaging Sphericity Medical technology R855-855.5
spellingShingle	Left atrium Volume assessment Shape Axis Cardiac magnetic resonance imaging Sphericity Medical technology R855-855.5 Jouni K. Kuusisto Pauli A. K. Pöyhönen Jani Pirinen Lauri J. Lehmonen Heli P. Räty Nicolas Martinez-Majander Jukka Putaala Juha Sinisalo Vesa Järvinen Revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis
description	Abstract Background Accurate measurement of left atrial (LA) volumes is needed in cardiac diagnostics and the follow up of heart and valvular diseases. Geometrical assumptions with 2D methods for LA volume estimation contribute to volume misestimation. In this study, we test agreement of 3D and 2D methods of LA volume detection and explore contribution of 3D LA axis orientation and LA shape in introducing error in 2D methods by cardiovascular magnetic resonance imaging. Methods 30 patients with prior first-ever ischemic stroke and no known heart disease, and 30 healthy controls were enrolled (age 18–49) in a substudy of a prospective case–control study. All study subjects underwent cardiac magnetic resonance imaging and were pooled for this methodological study. LA volumes were calculated by biplane area-length method from both conventional long axis (LAVAL-LV) and LA long axis-oriented images (LAVAL-LA) and were compared to 3D segmented LA volume (LAVSAX) to assess accuracy of volume detection. 3D orientation of LA long axis to left ventricular (LV) long axis and to four-chamber plane were determined, and LA 3D sphericity indices were calculated to assess sources of error in LA volume calculation. Shapiro–Wilk test, Bland–Altman analysis, intraclass and Pearson correlation, and Spearman’s rho were used for statistical analysis. Results Biases were − 9.9 mL (− 12.5 to − 7.2) for LAVAL-LV and 13.4 (10.0–16.9) for LAVAL-LA [mean difference to LAVSAX (95% confidence interval)]. End-diastolic LA long axis 3D deviation angle to LV long axis was 28.3 ± 6.2° [mean ± SD] and LA long axis 3D rotation angle to four-chamber plane 20.5 ± 18.0°. 3D orientation of LA axis or 3D sphericity were not correlated to error in LA volume calculation. Conclusions Calculated LA volume accuracy did not improve by using LA long axis-oriented images for volume calculation in comparison to conventional method. We present novel data on LA axis orientation and a novel metric of LA sphericity and conclude that these measures cannot be utilized to assess error in LA volume calculation. Trial registration Main study Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725) has been registered previously.
format	article
author	Jouni K. Kuusisto Pauli A. K. Pöyhönen Jani Pirinen Lauri J. Lehmonen Heli P. Räty Nicolas Martinez-Majander Jukka Putaala Juha Sinisalo Vesa Järvinen
author_facet	Jouni K. Kuusisto Pauli A. K. Pöyhönen Jani Pirinen Lauri J. Lehmonen Heli P. Räty Nicolas Martinez-Majander Jukka Putaala Juha Sinisalo Vesa Järvinen
author_sort	Jouni K. Kuusisto
title	Revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis
title_short	Revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis
title_full	Revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis
title_fullStr	Revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis
title_full_unstemmed	Revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis
title_sort	revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3d angle between left ventricular and left atrial axis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/635923c3bac14fe286a8b7054d77bfd5
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Revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis

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