Cardiovascular magnetic resonance myocardial feature tracking detects quantitative wall motion during dobutamine stress
Cardiovascular magnetic resonance myocardial feature tracking detects quantitative wall motion during dobutamine stress
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DOI：
10.1186/1532-429x-13-58
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发表时间：
2011-10-12
影响因子：
6.4
通讯作者：
Nagel, Eike
中科院分区：
文献类型：
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作者：
Schuster, Andreas;Kutty, Shelby;Nagel, Eike
背景：多巴酚丁胺负荷心血管磁共振（DS-CMR）是评估冬眠心肌和缺血的一种成熟工具。分析通常基于具有相当大的操作员依赖性的视觉评估。CMR心肌特征跟踪（CMR-FT）是最近引入的一种技术，用于在标准稳态自由进动（SSFP）图像上进行组织体素运动跟踪，以导出周向和径向心肌力学。我们试图确定CMR-FT定量室壁运动评估的可行性和重现性在中等剂量DS-CMR.Methods：10名健康受试者进行了研究，在1.5特斯拉。使用专用CMR-FT软件（Diogenes MRI prototype; Tomtec;德国）从SSFP电影图像中获得心肌应变参数。右心室（RV）和左心室（LV）纵向应变（Ell（RV）和Ell（LV））和LV长轴径向应变（Err（LAX））来自静息时的4腔视图。左心室短轴周向应变（Ecc（SAX））和Err（SAX）;左心室射血分数（EF）和体积进行了分析，在休息和多巴酚丁胺负荷（10和20 μ g . kg（-1）。结果：所有受试者均能从静态和应力状态下的SSFP图像中获得应变参数。Ecc（SAX）值显示DSMR显著增加的收缩（静息：-24.1 +/- 6.7; 10 μ g：-32.7 +/- 11.4; 20 μ g：-39.2 +/- 15.2; p < 0.05）。多巴酚丁胺显著增加Err（SAX）（静息：19.6 +/- 14.6; 10 μ g：31.8 +/- 20.9; 20 μ g：42.4 +/- 25.5; p < 0.05）。与这些变化平行，多巴酚丁胺组EF显著增加（静息：56.9 +/- 4.4%; 10 μ g：70.7 +/- 8.1; 20 μ g：76.8 +/- 4.6; p < 0.05）。观察变异性最好的左心室周向应变（Ecc（SAX））和最差的RV纵向应变（Ell（RV））确定的95%置信区间的差异。结论：CMR-FT可靠地检测定量室壁运动和应变来自SSFP电影成像，对应于正性肌力刺激。目前的实现可能需要改进，以减少干扰引起的方差。在给定的CMR实验室内，这种新技术有望轻松快速地量化壁力学和应变。
Background: Dobutamine stress cardiovascular magnetic resonance (DS-CMR) is an established tool to assess hibernating myocardium and ischemia. Analysis is typically based on visual assessment with considerable operator dependency. CMR myocardial feature tracking (CMR-FT) is a recently introduced technique for tissue voxel motion tracking on standard steady-state free precession (SSFP) images to derive circumferential and radial myocardial mechanics. We sought to determine the feasibility and reproducibility of CMR-FT for quantitative wall motion assessment during intermediate dose DS-CMR.Methods: 10 healthy subjects were studied at 1.5 Tesla. Myocardial strain parameters were derived from SSFP cine images using dedicated CMR-FT software (Diogenes MRI prototype; Tomtec; Germany). Right ventricular (RV) and left ventricular (LV) longitudinal strain (Ell(RV) and Ell(LV)) and LV long-axis radial strain (Err(LAX)) were derived from a 4-chamber view at rest. LV short-axis circumferential strain (Ecc(SAX)) and Err(SAX); LV ejection fraction (EF) and volumes were analyzed at rest and during dobutamine stress (10 and 20 mu g . kg(-1) . min(-1)).Results: In all volunteers strain parameters could be derived from the SSFP images at rest and stress. Ecc(SAX) values showed significantly increased contraction with DSMR (rest: -24.1 +/- 6.7; 10 mu g: -32.7 +/- 11.4; 20 mu g: -39.2 +/- 15.2; p < 0.05). Err(SAX) increased significantly with dobutamine (rest: 19.6 +/- 14.6; 10 mu g: 31.8 +/- 20.9; 20 mu g: 42.4 +/- 25.5; p < 0.05). In parallel with these changes; EF increased significantly with dobutamine (rest: 56.9 +/- 4.4%; 10 mu g: 70.7 +/- 8.1; 20 mu g: 76.8 +/- 4.6; p < 0.05). Observer variability was best for LV circumferential strain (Ecc(SAX)) and worst for RV longitudinal strain (Ell(RV)) as determined by 95% confidence intervals of the difference.Conclusions: CMR-FT reliably detects quantitative wall motion and strain derived from SSFP cine imaging that corresponds to inotropic stimulation. The current implementation may need improvement to reduce observer-induced variance. Within a given CMR lab; this novel technique holds promise of easy and fast quantification of wall mechanics and strain.