Page 28 - Journal of Structural Heart Disease Volume 5, Issue 3

67 Original Scientific Article
Figure 4. Bland Altman plot of anteroposterior angiogram versus cSSFP MRI in coronal plane.
Figure 5. Bland Altman plot of lateral angiogram versus cSSFP MRI in sagittal plane.
0.01), MRA larger diameter (r = 0.51, p = 0.07), MRA smaller diameter (r = 0.30, p = 0.3), 3D-SSFP larger diameter (r = 0.62, p = 0.01), and 3D-SSFP smaller diameter (r = 0.43, p = 0.1). BWD in the lateral view (Figure 3) was compared to sagittal plane of cSS- FP images (r = 0.67, p < 0.01), MRA larger diameter (r = 0.60, p = 0.01), MRA smaller diameter (r = 0.25, p = 0.4), 3D-SSFP larger diameter (r = 0.48, p = 0.06), and 3D-SSFP smaller diameter (r = 0.06, p = 1.0). CSS- FP measurements showed the strongest correlation and underwent Bland-Altman analysis for agreement (Figures 4 and 5). Bland-Altman analysis of BWD in the AP view compared to the cSSFP coronal plane showed a mean measurement difference of 0.50 ± 3.62 mm (95% CI -6.6-7.6). Bland-Altman analysis of BWD in the lateral view compared to the cSSFP sagit- tal plane showed a mean measurement difference of 0.54 ± 3.94 mm (95% CI -7.2-8.3).
Discussion
The present study’s results suggest that cardiac MRI can be a useful tool to predict which patients will be a candidate for PPVR based on RVOT size. To our knowl- edge, this is the first study to examine the ability of cardiac MRI to be used as a tool for PPVR candidate selection. The mean difference between the BWD and cSSFP measurements of the RVOT was only ~0.5 mm; however, the standard error around this point was wide. This indicates cardiac MRI only has a moderate capability to predict if percutaneous pulmonary valve implantation will be successful in patients with bor- derline RVOT size.
One difficulty with cardiac MRI’s ability to predict which candidates will be eligible based on RVOT size is distensibility. While cardiac MRI can account for some distensibilty and changes in size and shape of
Kurtz J. D. et al.
MRI vs Balloon Waist for Pulmonary Valve