Fig. 1

LV volumetry using CMRtools. The longitudinal LV main axis (black line in A) is defined from three representative short axis slices. Red points along the longitudinal main axis (B) illustrate localization of short axis slices where the longitudinal axis was set (diastole and systole, respectively). The LV endocardial contour (yellow circumscript in C) is set by manual definition of endocardial landmarks (red points in C) and propagating (yellow points along the endocardium in C) in a diastolic (shown) and systolic mid-papillary short axis slice. This contour is propagated for the other cardiac phases and the short axis stack. The resulting LV blood volume (including TPM) is visualized in long axis view (red color in D), and endocardial contour can be controlled (green circles in D). Exclusion of TPM (yellow in E) from the LV blood pool (red in E) is automatically provided by the software. Definition of mitral valve plane is done in 2- and 4-chamber views in diastole and systole (red line with arrows in F, left) to separate blood volumes of the atrium and ventricle. Mitral valve plane is shown (red rectangle in F, right) in a 3D geometric model of the LV. A third cardiac phase (mid-diastole) is selected in a mid-papillary short axis slice to manually correct for potential mismatch of the true and the propagated endocardial border (yellow circumscript of red area in G). The impact of considering this third cardiac phase becomes obvious comparing the time-volume curves without (white curve in H) and with (yellow curve in H) adjustment of endocardial borders in the third phase. In a final fine-tuning step endocardial borders (yellow points in I) were controlled and adjusted where necessary in all three cardiac phases (diastole, systole, mid-diastole). Yellow arrow (upper left) indicates view direction of the temporal view (quasi M-Mode, upper right)