Published Online
on October 9, 2009

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Sarikouch, S. Articles by Beerbaum, P. PubMed PubMed Citation Articles by Sarikouch, S. Articles by Beerbaum, P. Related Collections Epidemiology CT and MRI

Original Article

Gender Specific Pediatric Percentiles for Ventricular Size and Mass As Reference Values for Cardiac Magnetic Resonance Imaging

Samir Sarikouch^1,8; Titus Kuehne²; Brigitte Peters³; Matthias Gutberlet⁴; Birte Leismann⁵; Andrea Kelter—Kloepping⁵; Hermann Koerperich⁶ and Philipp Beerbaum⁷

¹ Hannover Medical School, Hannover & University of Bochum, Bochum, Germany;
² Deutsches Herzzentrum Berlin, Berlin, Germany;
³ University of Magdeburg, Magdeburg, Germany;
⁴ University of Leipzig, Leipzig, Germany;
⁵ University of Bochum, Bochum, Germany;
⁶ Inst for Radiology, Nucl Med and Molecular Imag, Heart & Diabetes Ctr, Bad Oeynhausen, Germany;
⁷ King's College London, Guy's & St. Thomas' Hospital, London, United Kingdom

^* Corresponding author; email: sarikouch.samir{at}mh-hannover.de

Background—Cardiac magnetic resonance imaging (MRI) is important in the management of children with congenital heart disease but sufficient normative data are lacking. For ventricular volumes and mass, we sought to deliver reference centiles and to investigate gender effects.

Methods and Results—We included 114 healthy children and adolescents, uniformly distributed spanning an age range of 4 to 20 years, as required by the Lambda-Mu-Sigma (LMS)-method to achieve a percentile distribution, thus avoiding arbitrary age categories. Subjects underwent axial volumetry (1.5-Tesla scanner) using standardized 2D steady-state free-precession and flow protocols. Percentiles were computed for age 8-20 years (99 subjects) as breathholds were more consistent in this group. When indexed for body surface area (BSA) or height, the centile curves of ventricular volumetric parameters showed allometric increase until adolescence, when a plateau was reached, with values comparable to published adult reference data. In contrast, ventricular mass centiles increased without plateau. There was a significant gender difference with centiles reflecting larger values in boys than in girls (p<0.05) when ventricular volumes were indexed to BSA or height, but not when indexed to weight (exception: mass). There was excellent agreement of axial and short-axis volumetry, and of volumetric and flow-derived stroke volumes.

Conclusions—Percentiles for ventricular volumes and mass in healthy children have been established to serve as reference values in pediatric heart disease. Significant gender differences were noted when indexing volumes to BSA or height. Unisex centiles related to weight may be considered for chamber volumes albeit not for mass.

Key Words: heart defects, congenital • heart diseases • magnetic resonance imaging • pediatrics • volumetry