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The Role of Magnetic Resonance Imaging and Cardiac Computed Tomography in the Assessment of Left Atrial Anatomy, Size, and Function.

Kuchynka P, Podzimkova J, Masek M, Lambert L, Cerny V, Danek B, Palecek T - Biomed Res Int (2015)

Bottom Line: In the last decade, there has been increasing evidence that comprehensive evaluation of the left atrium is of utmost importance.Numerous studies have clearly demonstrated the prognostic value of left atrial volume for long-term outcome.Furthermore, advances in catheter ablation procedures used for the treatment of drug-refractory atrial fibrillation require the need for detailed knowledge of left atrial and pulmonary venous morphology as well of atrial wall characteristics.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic ; International Clinical Research Center, St. Anne's University Hospital in Brno, Brno, Czech Republic.

ABSTRACT
In the last decade, there has been increasing evidence that comprehensive evaluation of the left atrium is of utmost importance. Numerous studies have clearly demonstrated the prognostic value of left atrial volume for long-term outcome. Furthermore, advances in catheter ablation procedures used for the treatment of drug-refractory atrial fibrillation require the need for detailed knowledge of left atrial and pulmonary venous morphology as well of atrial wall characteristics. This review article discusses the role of cardiac magnetic resonance and computed tomography in assessment of left atrial size, its normal and abnormal morphology, and function. Special interest is paid to the utility of these rapidly involving noninvasive imaging methods before and after atrial fibrillation ablation.

No MeSH data available.


Related in: MedlinePlus

Representative slice demonstrating the tracing of the left atrial boundary at ventricular end-systole in short-axis view on steady-state free precession magnetic resonance image. The left atrial volume is then calculated using the disk area summation method (Simpson's method) from contiguous slices covering the whole left atrial cavity.
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fig1: Representative slice demonstrating the tracing of the left atrial boundary at ventricular end-systole in short-axis view on steady-state free precession magnetic resonance image. The left atrial volume is then calculated using the disk area summation method (Simpson's method) from contiguous slices covering the whole left atrial cavity.

Mentions: Cardiac magnetic resonance has been considered the gold standard for assessment of the heart chambers [7]. Its high spatial and temporal resolution allows accurate assessment of the morphology and function of both the atria and ventricles in healthy subjects as well as in patients with various structural heart diseases. The advantage of CMR is the absence of radiation exposure and the ability to characterize tissue composition. Cine CMR images are obtained as end-expiratory breath-hold and ECG-triggered acquisitions with steady-state free precession sequences. Consecutive multislice acquisitions of the entire LA in short-axis view with either manual tracing of the atrial wall or automated border detection form basis for the assessment of LA volumes based on Simpson's method of discs (Figure 1). Slice thickness is usually between 2.5 and 5 mm, with a temporal resolution of 25 to 50 ms. Alternatively, LA volumes may be measured using the biplane area-length method in the horizontal and vertical long axes [8]. Left atrial area shall be measured in four-chamber view (Figure 2). The uniqueness of CMR as compared to echocardiography as well as cardiac CT is its ability of tissue characterization and scar imaging using late gadolinium enhancement (LGE) technique [8]. Inversion recovery gradient echo sequences in long and short axes are acquired 10–20 minutes after the injection of gadolinium-based contrast agent. Gadolinium-enhanced three-dimensional magnetic resonance angiography provides detailed information on pulmonary vein anatomy in relation to the LA cavity (Figure 3). If contrast agent administration is contraindicated, three-dimensional steady-state free precession angiography may be a viable option for how to assess anatomy of pulmonary veins and the LA.


The Role of Magnetic Resonance Imaging and Cardiac Computed Tomography in the Assessment of Left Atrial Anatomy, Size, and Function.

Kuchynka P, Podzimkova J, Masek M, Lambert L, Cerny V, Danek B, Palecek T - Biomed Res Int (2015)

Representative slice demonstrating the tracing of the left atrial boundary at ventricular end-systole in short-axis view on steady-state free precession magnetic resonance image. The left atrial volume is then calculated using the disk area summation method (Simpson's method) from contiguous slices covering the whole left atrial cavity.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4508386&req=5

fig1: Representative slice demonstrating the tracing of the left atrial boundary at ventricular end-systole in short-axis view on steady-state free precession magnetic resonance image. The left atrial volume is then calculated using the disk area summation method (Simpson's method) from contiguous slices covering the whole left atrial cavity.
Mentions: Cardiac magnetic resonance has been considered the gold standard for assessment of the heart chambers [7]. Its high spatial and temporal resolution allows accurate assessment of the morphology and function of both the atria and ventricles in healthy subjects as well as in patients with various structural heart diseases. The advantage of CMR is the absence of radiation exposure and the ability to characterize tissue composition. Cine CMR images are obtained as end-expiratory breath-hold and ECG-triggered acquisitions with steady-state free precession sequences. Consecutive multislice acquisitions of the entire LA in short-axis view with either manual tracing of the atrial wall or automated border detection form basis for the assessment of LA volumes based on Simpson's method of discs (Figure 1). Slice thickness is usually between 2.5 and 5 mm, with a temporal resolution of 25 to 50 ms. Alternatively, LA volumes may be measured using the biplane area-length method in the horizontal and vertical long axes [8]. Left atrial area shall be measured in four-chamber view (Figure 2). The uniqueness of CMR as compared to echocardiography as well as cardiac CT is its ability of tissue characterization and scar imaging using late gadolinium enhancement (LGE) technique [8]. Inversion recovery gradient echo sequences in long and short axes are acquired 10–20 minutes after the injection of gadolinium-based contrast agent. Gadolinium-enhanced three-dimensional magnetic resonance angiography provides detailed information on pulmonary vein anatomy in relation to the LA cavity (Figure 3). If contrast agent administration is contraindicated, three-dimensional steady-state free precession angiography may be a viable option for how to assess anatomy of pulmonary veins and the LA.

Bottom Line: In the last decade, there has been increasing evidence that comprehensive evaluation of the left atrium is of utmost importance.Numerous studies have clearly demonstrated the prognostic value of left atrial volume for long-term outcome.Furthermore, advances in catheter ablation procedures used for the treatment of drug-refractory atrial fibrillation require the need for detailed knowledge of left atrial and pulmonary venous morphology as well of atrial wall characteristics.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic ; International Clinical Research Center, St. Anne's University Hospital in Brno, Brno, Czech Republic.

ABSTRACT
In the last decade, there has been increasing evidence that comprehensive evaluation of the left atrium is of utmost importance. Numerous studies have clearly demonstrated the prognostic value of left atrial volume for long-term outcome. Furthermore, advances in catheter ablation procedures used for the treatment of drug-refractory atrial fibrillation require the need for detailed knowledge of left atrial and pulmonary venous morphology as well of atrial wall characteristics. This review article discusses the role of cardiac magnetic resonance and computed tomography in assessment of left atrial size, its normal and abnormal morphology, and function. Special interest is paid to the utility of these rapidly involving noninvasive imaging methods before and after atrial fibrillation ablation.

No MeSH data available.


Related in: MedlinePlus