Assessment of the precision and reproducibility of ventricular volume, function, and mass measurements with ferumoxytol-enhanced 4D flow MRI.
Assessment of the precision and reproducibility of ventricular volume, function, and mass measurements with ferumoxytol-enhanced 4D flow MRI.
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DOI：
10.1002/jmri.25180
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发表时间：
2016-08
期刊：
影响因子：
--
通讯作者：
Vasanawala SS
中科院分区：
文献类型：
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作者：
Hanneman K;Kino A;Cheng JY;Alley MT;Vasanawala SS
比较三维时间分辨（4D）血流MRI与电影稳态自由进动（SSFP）心室容积、功能和质量定量的精密度和观察者间一致性。在获得研究委员会批准、知情同意和遵守HIPAA的情况下，前瞻性招募了22例连续先天性心脏病（CHD）患者（10例男性，6.4±4.8岁）接受3 T ferumoxytol增强心脏MRI。获得了标准2D短轴电影SSFP的完全心室覆盖和轴向4D血流的全胸部覆盖。两名设盲放射科医师独立分割收缩末期（ES）和舒张末期（艾德）左心室（LV）和右心室（RV）心肌的图像。统计分析包括线性回归、方差分析、Bland-Altman（BA）分析和类内相关（ICC）。4D血流与SSFP之间的心室容积（r = 0.808-0.972，p<0.001）、射血分数（EF）（r = 0.900-928，p<0.001）和质量（r = 0.884-0.934，p<0.001）均呈显著正相关。两个心室的BA相对一致性范围分别为容积的−52%至34%、EF的−29%至27%和质量的−41%至48%，RV的一致性范围比LV更宽。两种技术在左心室（F=2.05，p=0.159）或右心室（F=0.625，p=0.434）ED-ES质量的均方差方面无显著差异。4D血流（ICC 0.523-0.993）和SSFP（ICC 0.619-0.982）的观察者间一致性为中度至良好，置信区间重叠。心室容积、功能和质量的量化可以通过4D Flow MRI完成，其精确度和观察者间一致性与电影SSFP相当。
To compare the precision and inter-observer agreement of ventricular volume, function and mass quantification by three-dimensional time-resolved (4D) flow MRI relative to cine steady state free precession (SSFP). With research board approval, informed consent, and HIPAA compliance, 22 consecutive patients with congenital heart disease (CHD) (10 males, 6.4±4.8 years) referred for 3T ferumoxytol-enhanced cardiac MRI were prospectively recruited. Complete ventricular coverage with standard 2D short-axis cine SSFP and whole chest coverage with axial 4D flow were obtained. Two blinded radiologists independently segmented images for left ventricular (LV) and right ventricular (RV) myocardium at end systole (ES) and end diastole (ED). Statistical analysis included linear regression, ANOVA, Bland-Altman (BA) analysis, and intra-class correlation (ICC). Significant positive correlations were found between 4D flow and SSFP for ventricular volumes (r = 0.808–0.972, p<0.001), ejection fraction (EF) (r = 0.900–928, p<0.001), and mass (r = 0.884–0.934, p<0.001). BA relative limits of agreement for both ventricles were between −52% to 34% for volumes, −29% to 27% for EF, and −41% to 48% for mass, with wider limits of agreement for the RV compared to the LV. There was no significant difference between techniques with respect to mean square difference of ED-ES mass for either LV (F=2.05, p=0.159) or RV (F=0.625, p=0.434). Inter-observer agreement was moderate to good with both 4D flow (ICC 0.523–0.993) and SSFP (ICC 0.619–0.982), with overlapping confidence intervals. Quantification of ventricular volume, function and mass can be accomplished with 4D flow MRI with precision and inter-observer agreement comparable to that of cine SSFP.