采用单屏气多层TrueFISP磁共振成像快速评估左心室节段性室壁运动、射血分数和容积。

Rapid assessment of left ventricular segmental wall motion, ejection fraction, and volumes with single breath-hold, multi-slice TrueFISP MR imaging.

作者信息

Fieno David S, Thomson Louise E J, Slomka Piotr J, Abidov Aiden, Nishina Hidetaka, Chien Daisy, Hayes Sean W, Saouaf Rola, Germano Guido, Friedman John D, Berman Daniel S

机构信息

Department of Imaging (Division of Cardiology), and CSMC Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.

出版信息

J Cardiovasc Magn Reson. 2006;8(3):435-44. doi: 10.1080/10976640600575205.

DOI:10.1080/10976640600575205

PMID:16755829

Abstract

BACKGROUND AND OBJECTIVE

To reduce imaging time and complexity, we sought to determine whether single breath-hold, multi-slice TrueFISP (SB-MST) magnetic resonance imaging (MRI) method is comparable to standard multi-breath-hold, multi-slice TrueFISP (MB-MST) for assessment of left ventricular (LV) wall motion abnormality (WMA), volumes, and ejection fraction (EF).

METHODS AND RESULTS

We studied 62 patients having cardiac MRI at 1.5-Tesla. After acquiring standard MB-MST (one slice per breath-hold), SB-MST was performed, acquiring 3 short- and 2 long-axis views over only 20 heartbeats. Using both techniques, wall motion was scored using a 6-point, 17-segment LV model for all scans (62 patients x 2 techniques/patient = 124 scans) on two separate occasions. Separately, EF and ventricular volumes were evaluated using both MB-MST and SB-MST. For all analyses, MB-MST was considered the standard against which SB-MST was compared. Twenty-six of 62 patients exhibited at least one segmental WMA by MB-MST. Exact agreement for wall motion was found in 965/1054 segments (92%, kappa = 0.74, p < 0.001), and agreement was within 1 score point in 1010/1054 segments (96%). Considering a score >1 abnormal, exact agreement for presence of WMA was found in 131/193 segments (68%) abnormal by MB-MST and for absence of WMA in 838/861 segments (97%) normal by MB-MST. Agreement within 1 score point occurred in 167/193 abnormal (87%) and in 843/861 normal segments (98%). There were no significant differences in agreement between first and second read of the data. Variability of SB-MST on read one versus read two was small (5%, 996/1054 segments read identically, p = ns) and statistically identical to variability of MB-MST on read one versus read two (4%, 1007/1054 segments read identically, p = ns). For end-diastolic volumes, end-systolic volumes, and EF using SB-MST compared to MB-MST, mean differences were 9 +/- 15 ml, 6 +/- 12 ml, and 2 +/- 5%, and correlations were r = 0.97, 0.98 and 0.95, respectively.

CONCLUSION

SB-MST accurately assesses wall motion, volumes and EF. This approach may serve as a screening exam for assessment of WMA and, under select circumstances, may substitute for standard multi-breath-hold method in situations requiring rapid accurate assessments of LV function.

摘要

背景与目的

为减少成像时间和复杂性，我们试图确定单屏气多层TrueFISP（SB-MST）磁共振成像（MRI）方法在评估左心室（LV）壁运动异常（WMA）、容积和射血分数（EF）方面是否与标准的多屏气多层TrueFISP（MB-MST）相当。

方法与结果

我们对62例在1.5特斯拉进行心脏MRI检查的患者进行了研究。在获取标准的MB-MST（每屏气采集一层图像）后，进行SB-MST检查，仅用20次心跳就采集了3个短轴视图和2个长轴视图。使用这两种技术，在两个不同时间对所有扫描（62例患者×2种技术/患者 = 124次扫描）采用6分、17节段的左心室模型对壁运动进行评分。另外，使用MB-MST和SB-MST分别评估EF和心室容积。对于所有分析，MB-MST被视为与SB-MST进行比较的标准。62例患者中有26例通过MB-MST显示至少一个节段的WMA。在1054个节段中的965个节段（92%，kappa = 0.74，p < 0.001）发现壁运动完全一致，在1054个节段中的1010个节段（96%）一致性在1分以内。将评分>1视为异常，在MB-MST显示异常的193个节段中的131个节段（68%）发现WMA存在的完全一致性，在MB-MST显示正常的861个节段中的838个节段（97%）发现WMA不存在的完全一致性。在193个异常节段中的167个节段（87%）和861个正常节段中的843个节段（98%）一致性在1分以内。数据的第一次和第二次读取之间的一致性没有显著差异。SB-MST在第一次读取与第二次读取之间的变异性较小（5%，1054个节段中有996个节段读取相同，p = 无显著性差异），并且在统计学上与MB-MST在第一次读取与第二次读取之间的变异性相同（4%，1054个节段中有1007个节段读取相同，p = 无显著性差异）。与MB-MST相比，使用SB-MST测量的舒张末期容积、收缩末期容积和EF的平均差异分别为9±15 ml、6±12 ml和2±5%，相关性分别为r = 0.97、0.98和0.95。