A method for the determination of proximal pulmonary vein size using contrast-enhanced magnetic resonance angiography

Thomas H. Hauser, Susan B. Yeon, Seth McClennen, George Katsimaglis, Kraig V. Kissinger, Mark E. Josephson, Neil M. Rofsky, Warren J. Manning

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objectives: We sought to develop a reproducible method for characterizing the anatomy of the proximal pulmonary veins. Background: Contrast-enhanced three-dimensional magnetic resonance angiography (CE-MRA) is a commonly requested test before and after radiofrequency ablation for the treatment of atrial fibrillation. While CE-MRA readily visualizes the pulmonary veins, there is no standardized method for determining their size and cross-sectional anatomy. Methods: Data for 24 consecutive patients referred for pulmonary vein CE-MRA before an elective ablation procedure for the treatment of atrial fibrillation were analyzed. Detailed measurements of the pulmonary vein diameter, circumference, and cross-sectional area were obtained at three locations: the juncture of the pulmonary vein with the left atrium (LA) (position 1ι), the narrowest segment within 5 mm of the juncture (position 25mm), and at the location in the sagittal plane at which the pulmonary veins separate from the LA and from each other (position 3 Sag). Intraobserver and interobserver variabilities were also determined for each method. Results: The left lower pulmonary vein was significantly smaller than the other pulmonary veins at positions 1 ι and 25mm (p<0.05). The right upper pulmonary vein was significantly larger than the other pulmonary vein at position 3 Sag (p<0.05). At positions 1ι and 25mm, the diameter had a low correlation with the circumference and cross-sectional area. At position 3Sag, the major and minor axis dimensions had a very high correlation with the circumference and cross-sectional area. The intraobserver and interobserver variabilities were substantially lower (better) for position 3Sag. Conclusions: Pulmonary vein diameter measurements are highly variable and do not reflect true anatomic variation in cross-sectional anatomy. A sagittal method of determining pulmonary vein size was highly reproducible and may therefore be advantageous for use in patients likely to need serial examinations.

Original languageEnglish (US)
Pages (from-to)927-936
Number of pages10
JournalJournal of Cardiovascular Magnetic Resonance
Volume6
Issue number4
DOIs
StatePublished - 2004

Fingerprint

Pulmonary Veins
Magnetic Resonance Angiography
Cross-Sectional Anatomy
Observer Variation
Heart Atria
Atrial Fibrillation
Anatomic Variation
Anatomy

Keywords

  • Angiography
  • Magnetic resonance
  • Pulmonary vein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Family Practice

Cite this

Hauser, T. H., Yeon, S. B., McClennen, S., Katsimaglis, G., Kissinger, K. V., Josephson, M. E., ... Manning, W. J. (2004). A method for the determination of proximal pulmonary vein size using contrast-enhanced magnetic resonance angiography. Journal of Cardiovascular Magnetic Resonance, 6(4), 927-936. https://doi.org/10.1081/JCMR-200037474

A method for the determination of proximal pulmonary vein size using contrast-enhanced magnetic resonance angiography. / Hauser, Thomas H.; Yeon, Susan B.; McClennen, Seth; Katsimaglis, George; Kissinger, Kraig V.; Josephson, Mark E.; Rofsky, Neil M.; Manning, Warren J.

In: Journal of Cardiovascular Magnetic Resonance, Vol. 6, No. 4, 2004, p. 927-936.

Research output: Contribution to journalArticle

Hauser, Thomas H. ; Yeon, Susan B. ; McClennen, Seth ; Katsimaglis, George ; Kissinger, Kraig V. ; Josephson, Mark E. ; Rofsky, Neil M. ; Manning, Warren J. / A method for the determination of proximal pulmonary vein size using contrast-enhanced magnetic resonance angiography. In: Journal of Cardiovascular Magnetic Resonance. 2004 ; Vol. 6, No. 4. pp. 927-936.
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T1 - A method for the determination of proximal pulmonary vein size using contrast-enhanced magnetic resonance angiography

AU - Hauser, Thomas H.

AU - Yeon, Susan B.

AU - McClennen, Seth

AU - Katsimaglis, George

AU - Kissinger, Kraig V.

AU - Josephson, Mark E.

AU - Rofsky, Neil M.

AU - Manning, Warren J.

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N2 - Objectives: We sought to develop a reproducible method for characterizing the anatomy of the proximal pulmonary veins. Background: Contrast-enhanced three-dimensional magnetic resonance angiography (CE-MRA) is a commonly requested test before and after radiofrequency ablation for the treatment of atrial fibrillation. While CE-MRA readily visualizes the pulmonary veins, there is no standardized method for determining their size and cross-sectional anatomy. Methods: Data for 24 consecutive patients referred for pulmonary vein CE-MRA before an elective ablation procedure for the treatment of atrial fibrillation were analyzed. Detailed measurements of the pulmonary vein diameter, circumference, and cross-sectional area were obtained at three locations: the juncture of the pulmonary vein with the left atrium (LA) (position 1ι), the narrowest segment within 5 mm of the juncture (position 25mm), and at the location in the sagittal plane at which the pulmonary veins separate from the LA and from each other (position 3 Sag). Intraobserver and interobserver variabilities were also determined for each method. Results: The left lower pulmonary vein was significantly smaller than the other pulmonary veins at positions 1 ι and 25mm (p<0.05). The right upper pulmonary vein was significantly larger than the other pulmonary vein at position 3 Sag (p<0.05). At positions 1ι and 25mm, the diameter had a low correlation with the circumference and cross-sectional area. At position 3Sag, the major and minor axis dimensions had a very high correlation with the circumference and cross-sectional area. The intraobserver and interobserver variabilities were substantially lower (better) for position 3Sag. Conclusions: Pulmonary vein diameter measurements are highly variable and do not reflect true anatomic variation in cross-sectional anatomy. A sagittal method of determining pulmonary vein size was highly reproducible and may therefore be advantageous for use in patients likely to need serial examinations.

AB - Objectives: We sought to develop a reproducible method for characterizing the anatomy of the proximal pulmonary veins. Background: Contrast-enhanced three-dimensional magnetic resonance angiography (CE-MRA) is a commonly requested test before and after radiofrequency ablation for the treatment of atrial fibrillation. While CE-MRA readily visualizes the pulmonary veins, there is no standardized method for determining their size and cross-sectional anatomy. Methods: Data for 24 consecutive patients referred for pulmonary vein CE-MRA before an elective ablation procedure for the treatment of atrial fibrillation were analyzed. Detailed measurements of the pulmonary vein diameter, circumference, and cross-sectional area were obtained at three locations: the juncture of the pulmonary vein with the left atrium (LA) (position 1ι), the narrowest segment within 5 mm of the juncture (position 25mm), and at the location in the sagittal plane at which the pulmonary veins separate from the LA and from each other (position 3 Sag). Intraobserver and interobserver variabilities were also determined for each method. Results: The left lower pulmonary vein was significantly smaller than the other pulmonary veins at positions 1 ι and 25mm (p<0.05). The right upper pulmonary vein was significantly larger than the other pulmonary vein at position 3 Sag (p<0.05). At positions 1ι and 25mm, the diameter had a low correlation with the circumference and cross-sectional area. At position 3Sag, the major and minor axis dimensions had a very high correlation with the circumference and cross-sectional area. The intraobserver and interobserver variabilities were substantially lower (better) for position 3Sag. Conclusions: Pulmonary vein diameter measurements are highly variable and do not reflect true anatomic variation in cross-sectional anatomy. A sagittal method of determining pulmonary vein size was highly reproducible and may therefore be advantageous for use in patients likely to need serial examinations.

KW - Angiography

KW - Magnetic resonance

KW - Pulmonary vein

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