Assessment of systolic left ventricular function: a multi-centre comparison of cineventriculography, cardiac magnetic resonance imaging, unenhanced and contrast-enhanced echocardiography
Assessment of systolic left ventricular function: a multi-centre comparison of cineventriculography, cardiac magnetic resonance imaging, unenhanced and contrast-enhanced echocardiography
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DOI：
10.1093/eurheartj/ehi083
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发表时间：
2005-03-01
影响因子：
39.3
通讯作者：
Vanoverschelde, JL
中科院分区：
文献类型：
--
作者：
Hoffmann, R;von Bardeleben, S;Vanoverschelde, JL
目的评估非增强超声心动图、对比增强超声心动图、磁共振成像（MRI）和电影心动图测定左室射血分数（LVEF）的一致性，以及每种方法的观察者间一致性。方法和结果将120例患者分为均匀分布的ef组（> 55、35-55、< 35%），在静脉给药SonoVue (R)的情况下，分别进行心室造影、无增强超声心动图二次谐波成像和两项力学指标超声造影。此外，55名患者在1.5T时使用稳态自由进动序列进行心脏MRI。根据预先定义的标准，进行现场和两次非现场盲法评估，包括无增强和对比超声心动图、心室造影和MRI。确定类内相关系数（ICCs）以评估所有三个读者（即一个现场和两个非现场）之间的观察者间可靠性。超声心动图检查EF为56.2 +/- 18.3%，MRI检查为54.1 +/- 12.9%，超声心动图检查为50.9 +/- 15.3%，超声心动图检查为54.6 +/- 16.8%。超声心动图与电影心动图EF的相关性由未增强超声心动图的0.72上升至对比超声心动图的0.83 （P < 0.05）。同样，MRI与超声心动图EF的相关性由未增强超声心动图的0.60上升至对比超声心动图的0.77 （P < 0.05）。对比超声心动图的观察者间信度ICC为0.91 (95% CI 0.88-0.94)，其次是心脏MRI （0.86; 95% CI 0.80-0.92）、心室造影（0.80;95% CI 0.74-0.85）和非增强超声心动图（0.79;95% CI 0.74-0.85）。结论未增强超声心动图与脑室造影和MRI的相关性不高，且有轻微低估。超声心动图造影结果更准确，并显著提高了与脑室造影和MRI的相关性。对比超声心动图与未增强超声心动图相比，显着提高了EF的观察者间一致性。对比超声心动图对EF的观察者间可靠性达到与MRI相当的水平，优于电影脑室造影。
Aims To assess the agreement of left ventricular ejection fraction (LVEF) determinations from unenhanced echocardiography, contrast-enhanced echocardiography, magnetic resonance imaging (MRI), and cineventriculography as well as the inter-observer agreement for each method.Methods and results In 120 patients, with evenly distributed EF-groups (> 55, 35-55, < 35%), cineventriculography, unenhanced echocardiography with second harmonic imaging, and contrast echocardiography at tow mechanical index with iv administration of SonoVue (R) were performed. In addition, cardiac MRI at 1.5T using a steady-state free precession sequence was performed in a subset of 55 patients. On-site, and two blinded off-site assessments were performed for unenhanced and contrast echocardiography, cineventricutography, and MRI according to pre-defined standards. Intra-class correlation coefficients (ICCs) were determined to assess inter-observer reliability between all three readers (i.e. one on-site and two off-site). EF was 56.2 +/- 18.3% by cineventriculography, 54.1 +/- 12.9% by MRI, 50.9 +/- 15.3% by unenhanced echocardiography, and 54.6 +/- 16.8% by contrast echocardiography. Correlation on EF between cineventricutography and echocardiography increased from 0.72 with unenhanced echocardiography to 0.83 with contrast echocardiography (P < 0.05). Similarly, correlation on EF between MRI and echocardiography increased from 0.60 with unenhanced echocardiography to 0.77 with contrast echocardiography (P < 0.05). The inter-observer reliability ICC was 0.91 (95% CI 0.88-0.94) in contrast echocardiography, followed by cardiac MRI (0.86; 95% CI 0.80-0.92), cineventricutography (0.80; 95% CI 0.74-0.85), and unenhanced echocardiography (0.79; 95% CI 0.74-0.85).Conclusions Unenhanced echocardiography resulted in slight underestimation of EF and only moderate correlation compared with cineventriculography and MRI. Contrast echocardiography resulted in more accurate EF and significantly improved correlation with cineventriculography and MRI. Contrast echocardiography significantly improved inter-observer agreement on EF compared with unenhanced echocardiography. Interobserver reliability on EF using contrast echocardiography reaches a level comparable to MRI and is better than those obtained by cineventriculography.