European Radiology

, Volume 28, Issue 1, pp 104–114 | Cite as

Left ventricular regional myocardial motion and twist function in repaired tetralogy of Fallot evaluated by magnetic resonance tissue phase mapping

  • Meng-Chu Chang
  • Ming-Ting Wu
  • Ken-Pen Weng
  • Mao-Yuan Su
  • Marius Menza
  • Hung-Chieh Huang
  • Hsu-Hsia PengEmail author
Magnetic Resonance



We aimed to characterise regional myocardial motion and twist function in the left ventricles (LV) in patients with repaired tetralogy of Fallot (rTOF) and preserved LV global function.


We recruited 47 rTOF patients and 38 age-matched normal volunteers. Tissue phase mapping (TPM) was performed for evaluating the LV myocardial velocity in longitudinal, radial, and circumferential (Vz, Vr, and VØ) directions in basal, middle, and apical slices. The VØ peak-to-peak (PTP) during systolic phases, the rotation angle of each slice, and VØ inconsistency were computed for evaluating LV twist function and VØ dyssynchrony.


As compared to the controls, the rTOF patients presented decreased RV ejection fraction (RVEF) (p = 0.002) and preserved global LV ejection fraction (LVEF). They also demonstrated decreased systolic and diastolic Vz in several LV segments and higher diastolic Vr in the septum (all p < 0.05). A lower VØ PTP, higher VØ inconsistency, and reduced peak net rotation angle (all p < 0.05) were observed. The aforementioned indices demonstrated an altered LV twist function in rTOF patients in an early disease stage.


MR TPM could provide information about early abnormalities of LV regional motion and twist function in rTOF patients with preserved LV global function.

Key points

Patients with rTOF presented significantly reduced systolic and diastolic Vz in the LV.

rTOF patients demonstrated significantly increased diastolic Vr in the septum.

Abnormal characteristics of the segmental dynamic velocity evolution were shown in rTOF.

rTOF patients presented altered circumferential rotation and velocity inconsistency in early stage.


Tetralogy of Fallot Tissue phase mapping Myocardial motion Twist Ventricular function 



ejection fraction


left ventricle


pulmonary regurgitation


peak to peak


repaired tetralogy of Fallot


right ventricle


tissue phase mapping




radial velocity

circumferential velocity


longitudinal velocity



Parts of the work have been presented in the 23rd Annual Meeting of International Society of Magnetic Resonance in Medicine, Toronto, Canada.

Compliance with ethical standards


The scientific guarantor of this publication is Dr. Hsu-Hsia Peng.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.


This study has received funding by the Veterans General Hospitals and University System of Taiwan Joint Research Program (VGHUST103-G3-1-1, VGHUST103-G3-1-2, VGHUST104-G7-7-1, VGHUST104-G7-7-2, and VGHUST104-G7-7-3). This study was also supported in part by Ministry of Science and Technology in Taiwan (NSC 102-2320-B-007-003-MY3).

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• prospective

• cross sectional study

• performed at one institution

Supplementary material

330_2017_4908_MOESM1_ESM.docx (2.6 mb)
ESM 1 (DOCX 2634 kb)


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.Department of Biomedical Engineering and Environmental SciencesNational Tsing Hua UniversityHsinchuTaiwan
  2. 2.Department of RadiologyKaohsiung Veterans General HospitalKaohsiungTaiwan
  3. 3.Faculty of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  4. 4.Department of PediatricsKaohsiung Veterans General HospitalKaohsiungTaiwan
  5. 5.Department of Physical TherapyShu-Zen Junior College of Medicine and ManagementKaohsiungTaiwan
  6. 6.Department of Medical ImagingNational Taiwan University HospitalTaipeiTaiwan
  7. 7.Department of Radiology, Medical PhysicsMedical Center University of Freiburg, Faculty of Medicine, University of FreiburgFreiburgGermany

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