Feature tracking compared with tissue tagging measurements of segmental strain by cardiovascular magnetic resonance.
Feature tracking compared with tissue tagging measurements of segmental strain by cardiovascular magnetic resonance.
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DOI：
10.1186/1532-429x-16-10
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发表时间：
2014-01-22
期刊：
影响因子：
--
通讯作者：
van Rossum AC
中科院分区：
文献类型：
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作者：
Wu L;Germans T;Güçlü A;Heymans MW;Allaart CP;van Rossum AC
左室节段性壁运动分析对心脏疾病的临床决策具有重要意义。心肌组织标记应变分析是定量评估的无创金标准，但耗时较长。心血管磁共振心肌特征跟踪（CMR- ft）可以快速进行应变分析，因为它可以与标准的CMR电影成像一起使用。目的是验证CMR-FT对组织标记分析的节段收缩周应变峰值（peak SCS）和收缩周应变峰值时间（T2P-SCS），并确定其在观察者内部和观察者之间的可变性。选择同时进行CMR和组织标记的患者。采用心内膜（CMR-FTendo）和中壁轮廓（CMR-FTmid）进行CMR-FT分析。计算类内相关系数（ICC）和Pearson相关系数。健康志愿者10例，左束支阻滞（LBBB）患者10例，肥厚性心肌病患者10例。用CMR-FT分析480个片段，用组织标记464个片段。CMR-FTendo和组织标记在整个研究组的平均峰值SCS值之间存在显著差异（-23.8±9.9% vs -13.4±3.3%,p < 0.001）。CMR-FTmid和组织标记之间的差异较小（-16.4±6.1% vs -13.4±3.3%,p = 0.001）。CMR-FTendo与组织标记的总研究组平均峰SCS的ICC较低（0.19 (95%-CI-0.10-0.49), p = 0.02）。在CMR-FTmid和组织标记之间可以看到类似的结果。在LBBB患者中，CMR-FTendo和CMR-FTmid测量的tbp - scs平均值分别为418±66 ms、454±60 ms，比组织标记法（376±55 ms）长，p均< 0.05。CMR-FTendo与组织标记之间的tbp - scs的ICC平均值为0.64 (95%-CI-0.36-0.81), p < 0.001，在健康志愿者和LBBB组中较好，而CMR-FTmid与组织标记之间的ICC值较低。与组织标记相比，CMR-FTmid的节段性峰SCS在观察者内和观察者间的一致性较低；在T2P-SCS中也观察到类似的结果。与组织标记相比，CMR-FTmid对节段性峰值SCS和ttp -SCS的观察内和观察间一致性显著降低。因此，目前的分段CMR-FTmid技术还不能应用于临床和研究。
Left ventricular segmental wall motion analysis is important for clinical decision making in cardiac diseases. Strain analysis with myocardial tissue tagging is the non-invasive gold standard for quantitative assessment, however, it is time-consuming. Cardiovascular magnetic resonance myocardial feature-tracking (CMR-FT) can rapidly perform strain analysis, because it can be employed with standard CMR cine-imaging. The aim is to validate segmental peak systolic circumferential strain (peak SCS) and time to peak systolic circumferential strain (T2P-SCS) analysed by CMR-FT against tissue tagging, and determine its intra and inter-observer variability. Patients in whom both cine CMR and tissue tagging has been performed were selected. CMR-FT analysis was done using endocardial (CMR-FTendo) and mid-wall contours (CMR-FTmid). The Intra Class Correlation Coefficient (ICC) and Pearson correlation were calculated. 10 healthy volunteers, 10 left bundle branch block (LBBB) and 10 hypertrophic cardiomyopathy patients were selected. With CMR-FT all 480 segments were analyzable and with tissue tagging 464 segments. Significant differences in mean peak SCS values of the total study group were present between CMR-FTendo and tissue tagging (-23.8 ± 9.9% vs -13.4 ± 3.3%, p < 0.001). Differences were smaller between CMR-FTmid and tissue tagging (-16.4 ± 6.1% vs -13.4 ± 3.3%, p = 0.001). The ICC of the mean peak SCS of the total study group between CMR-FTendo and tissue tagging was low (0.19 (95%-CI-0.10-0.49), p = 0.02). Comparable results were seen between CMR-FTmid and tissue tagging. In LBBB patients, mean T2P-SCS values measured with CMR-FTendo and CMR-FTmid were 418 ± 66 ms, 454 ± 60 ms, which were longer than with tissue tagging, 376 ± 55 ms, both p < 0.05. ICC of the mean T2P-SCS between CMR-FTendo and tissue tagging was 0.64 (95%-CI-0.36-0.81), p < 0.001, this was better in the healthy volunteers and LBBB group, whereas the ICC between CMR-FTmid and tissue tagging was lower. The intra and inter-observer agreement of segmental peak SCS with CMR-FTmid was lower compared with tissue tagging; similar results were seen for segmental T2P-SCS. The intra and inter-observer agreement of segmental peak SCS and T2P-SCS is substantially lower with CMR-FTmid compared with tissue tagging. Therefore, current segmental CMR-FTmid techniques are not yet applicable for clinical and research purposes.