Reproducibility and its confounders of CMR feature tracking myocardial strain analysis in patients with suspected myocarditis.
Reproducibility and its confounders of CMR feature tracking myocardial strain analysis in patients with suspected myocarditis.
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DOI：
10.1007/s00330-021-08416-5
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发表时间：
2022-05
影响因子：
5.9
通讯作者：
中科院分区：
文献类型：
--
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心血管磁共振特征跟踪（CMR-FT）是一种评估心肌应变的新兴技术，具有诊断和预后价值。然而，尚未评估大规模心血管人群中双心室CMR-FT分析的重现性。此外，影响患者CMR-FT读片员再现性的混杂因素的证据尚不清楚，目前限制了该技术的临床实施。从因疑似心肌炎而转诊至CMR的患者的双中心数据库中，随机选择125例患者进行双心室CMR-FT分析，以进行二维收缩和舒张测量，并对左心室进行额外的三维分析。所有图像分析均由一名阅片人重复进行，并由第二名阅片人进行阅片人内和阅片人间分析（Circle Cardiovascular Imaging）。采用组内相关性（ICC）检验进行可靠性检验，通过多变量分析评估影像学混杂因素对一致性的影响。左心室和右心室射血分数分别减少34%和37%的患者。对于两个心室的2D（所有ICC> 0.85）和3D（所有ICC> 0.70）峰值应变和舒张早期应变率，在纵向方向以及左心室的周向方向上显示了良好至极好的可靠性。增加切片数可改善一致性，而心包积液的存在则会损害舒张期应变率一致性，心律失常则会损害右心室一致性。在一个大型临床队列中，我们可以证明CMR-FT具有出色的阅片人间和阅片人内重现性。右心室和左心室的多参数CMR-FT似乎是涉及CMR的心血管患者的一个强大工具。临床试验注册。ClinicalTrials.gov 心血管磁共振特征跟踪（CMR-FT）是一种新兴技术，用于测量因CMR转诊的心血管患者的心肌应变;然而，尚未在大型队列中对其重现性进行评估。·在大型临床队列中，CMR-FT可为左右心室收缩和舒张参数提供出色的阅片者间和阅片者内重现性。·心律失常和心包积液会影响所选FT参数的一致性，但射血分数不差。在线版本包含补充材料，可通过10.1007/s00330 - 021 - 08416 - 5获取。
Cardiovascular magnetic resonance feature tracking (CMR-FT) is an emerging technique for assessing myocardial strain with valuable diagnostic and prognostic potential. However, the reproducibility of biventricular CMR-FT analysis in a large cardiovascular population has not been assessed. Also, evidence of confounders impacting reader reproducibility for CMR-FT in patients is unknown and currently limits the clinical implementation of this technique. From a dual-center database of patients referred to CMR for suspected myocarditis, 125 patients were randomly selected to undergo biventricular CMR-FT analysis for 2-dimensional systolic and diastolic measures, with additional 3-dimensional analysis for the left ventricle. All image analysis was replicated by a single reader and by a second reader for intra- and inter-reader analysis (Circle Cardiovascular Imaging). Reliability was tested with intraclass correlation (ICC) tests, and the impact of imaging confounders on agreement was assessed through multivariable analysis. Left and right ventricular ejection fractions were reduced in 34% and 37% of the patients, respectively. Good to excellent reliability was shown for 2D (all ICC > 0.85) and 3D (all ICC > 0.70) peak strain and early diastolic strain rate for both ventricles in longitudinal orientation as well as circumferential orientations for the left ventricle. An increased slice number improved agreement while the presence of pericardial effusion compromised diastolic strain rate agreement, and arrhythmia compromised right ventricular agreement. In a large clinical cohort, we could show CMR-FT yields excellent inter-reader and intra-reader reproducibility. Multi-parametric CMR-FT of the right and left ventricles appears to be a robust tool in cardiovascular patients referred to CMR. Clinical trial registration. ClinicalTrials.gov Identifier: NCT03470571, NCT04774549. Key Points • Cardiovascular magnetic resonance feature tracking (CMR-FT) is an emerging technique to measure myocardial strain in cardiovascular patients referred for CMR; however, the evaluation of its reproducibility in a large cohort has not yet been performed. • In a large clinical cohort, CMR-FT yields excellent inter-reader and intra-reader reproducibility for both left and right ventricular systolic and diastolic parameters. • Arrhythmia and pericardial effusion compromise agreement of select FT parameters, but poor ejection fraction does not. The online version contains supplementary material available at 10.1007/s00330-021-08416-5.
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