使用快速三维梯度回波脉冲序列评估左心室功能：与标准多次屏气二维稳态自由进动成像的比较以及对乳头肌和小梁的考量

Left ventricular function assessment using a fast 3D gradient echo pulse sequence: comparison to standard multi-breath hold 2D steady state free precession imaging and accounting for papillary muscles and trabeculations.

作者信息

Sievers Burkhard, Schrader Sebastian, Rehwald Wolfgang, Hunold Peter, Barkhausen Joerg, Erbel Raimund

机构信息

Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Duesseldorf, Duesseldorf, Germany.

出版信息

Acta Cardiol. 2011 Jun;66(3):349-57. doi: 10.1080/ac.66.3.2114135.

DOI:10.1080/ac.66.3.2114135

PMID:21744705

Abstract

OBJECTIVE

Papillary muscles and trabeculae for ventricular function analysis are known to significantly contribute to accurate volume and mass measurements. Fast imaging techniques such as three-dimensional steady-state free precession (3D SSFP) are increasingly being used to speed up imaging time, but sacrifice spatial resolution. It is unknown whether 3D SSFP, despite its reduced spatial resolution, allows for exact delineation of papillary muscles and trabeculations. We therefore compared 3D SSFP ventricular function measurements to those measured from standard multi-breath hold two-dimensional steady-state free precession cine images (standard 2D SSFP).

METHODS AND RESULTS

14 healthy subjects and 14 patients with impaired left ventricularfunction underwent 1.5 Tesla cine imaging. A stack of short axis images covering the left ventricle was acquired with 2D SSFP and 3D SSFP. Left ventricular volumes, ejection fraction, and mass were determined. Analysis was performed by substracting papillary muscles and trabeculae from left ventricular volumes. In addition, reproducibility was assessed. EDV, ESV, EF, and mass were not significantly different between 2D SSFP and 3D SSFP (mean difference healthy subjects: -0.06 +/- 3.2 ml, 0.54 +/- 2.2 ml, -0.45 +/- 1.8%, and 1.13 +/- 0.8 g, respectively; patients: 1.36 +/- 2.8 ml, -0.15 3.5 ml, 0.86 +/- 2.5%, and 0.91 +/- 0.9 g, respectively; P > or = 0.095). Intra- and interobserver variability was not different for 2D SSFP (P > or = 0.64 and P > or = 0.397) and 3D SSFP (P > or = 0.53 and P > or = 0.47).

CONCLUSIONS

Differences in volumes, EF, and mass measurements between 3D SSFP and standard 2D SSFP are very small, and not statistically significant. 3D SSFP may be used for accurate ventricular function assessment when papillary muscles and trabeculations are to be taken into account.

摘要

目的

已知用于心室功能分析的乳头肌和小梁对准确的容积和质量测量有显著贡献。诸如三维稳态自由进动（3D SSFP）之类的快速成像技术越来越多地被用于加快成像时间，但会牺牲空间分辨率。尽管3D SSFP的空间分辨率降低，但其是否能精确描绘乳头肌和小梁尚不清楚。因此，我们将3D SSFP心室功能测量结果与从标准多屏气二维稳态自由进动电影图像（标准2D SSFP）测量的结果进行了比较。

方法与结果

14名健康受试者和14名左心室功能受损的患者接受了1.5特斯拉电影成像。使用2D SSFP和3D SSFP采集覆盖左心室的一叠短轴图像。测定左心室容积、射血分数和质量。通过从左心室容积中减去乳头肌和小梁进行分析。此外，评估了可重复性。2D SSFP和3D SSFP之间的舒张末期容积（EDV）、收缩末期容积（ESV）、射血分数（EF）和质量无显著差异（健康受试者的平均差异分别为：-0.06±3.2毫升、0.54±2.2毫升、-0.45±1.8%和1.13±0.8克；患者分别为：1.36±2.8毫升、-0.15±3.5毫升、0.86±2.5%和0.91±0.9克；P≥0.095）。2D SSFP（P≥0.64和P≥0.397）和3D SSFP（P≥0.53和P≥0.47）的观察者内和观察者间变异性无差异。