Automated 4-dimensional regional myocardial strain evaluation using cardiac computed tomography
Automated 4-dimensional regional myocardial strain evaluation using cardiac computed tomography
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DOI：
10.1007/s10554-019-01696-5
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发表时间：
2020-01-01
影响因子：
2.1
通讯作者：
Lessick, Jonathan
中科院分区：
文献类型：
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作者：
Peled, Zvi;Lamash, Yechiel;Lessick, Jonathan
心肌区域功能的评估通常是通过视觉“眼球”来进行的，这是高度主观的。需要一个可靠的区域功能可量化参数，以提供客观、可重复和可比较的心肌性能测量。我们的目的是评估心脏计算机断层扫描（CT）数据集的新型区域心肌应变软件的临床应用。该软件采用基于有限元的心脏周期跟踪算法，对93例连续接受回顾性门控心脏CT的患者进行了评估。计算16个心肌节段的周向（CS）、纵向（LS）和径向（RS）应变，并与由经验丰富的心脏病专家根据CT数据得出的标准“回声”视图的电影胶片进行的视觉评估进行比较。超声心动图对37例斑点应变进行了比较。自动化软件在93/106例病例中成功执行，人工干预最少。CS、LS和RS峰在正常、低运动和运动节段之间均有良好的分化。运动段的峰值通常在收缩期后出现，峰值在RR间期的50 +/- 17%，而正常运动段的峰值为43 +/- 9%。使用ROC分析来检验正常和异常段的区分能力，CS的曲线下面积为0.84 +/- 0.01，RS为0.80 +/- 0.02，LS为0.68 +/- 0.02。与斑点菌株有中等程度的一致性。CT数据集的自动四维区域应变分析与视觉分析具有良好的对应关系，能够成功区分正常段和异常段，从而提供了一个客观的可量化的心肌区域功能图。
Evaluation of myocardial regional function is generally performed by visual "eyeballing" which is highly subjective. A robust quantifiable parameter of regional function is required to provide an objective, repeatable and comparable measure of myocardial performance. We aimed to evaluate the clinical utility of novel regional myocardial strain software from cardiac computed tomography (CT) datasets. 93 consecutive patients who had undergone retrospectively gated cardiac CT were evaluated by the software, which utilizes a finite element based tracking algorithm through the cardiac cycle. Circumferential (CS), longitudinal (LS) and radial (RS) strains were calculated for each of 16 myocardial segments and compared to a visual assessment, carried out by an experienced cardiologist on cine movies of standard "echo" views derived from the CT data. A subset of 37 cases was compared to speckle strain by echocardiography. The automated software performed successfully in 93/106 cases, with minimal human interaction. Peak CS, LS and RS all differentiated well between normal, hypokinetic and akinetic segments. Peak strains for akinetic segments were generally post-systolic, peaking at 50 +/- 17% of the RR interval compared to 43 +/- 9% for normokinetic segments. Using ROC analysis to test the ability to differentiate between normal and abnormal segments, the area under the curve was 0.84 +/- 0.01 for CS, 0.80 +/- 0.02 for RS and 0.68 +/- 0.02 for LS. There was a moderate agreement with speckle strain. Automated 4D regional strain analysis of CT datasets shows a good correspondence to visual analysis and successfully differentiates between normal and abnormal segments, thus providing an objective quantifiable map of myocardial regional function.