Department of Diagnostic and Interventional Radiology, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
Eur Radiol. 2013 Jun;23(6):1546-52. doi: 10.1007/s00330-012-2752-3. Epub 2012 Dec 20.
Pulmonary vein (PV) diameter assessment is important for planning and follow-up of PV ablation in atrial fibrillation. Therefore, the aim of our study was to evaluate inter- and intraobserver reliability of PV diameter measurements by contrast-enhanced magnetic resonance angiography (CE-MRA) and ECG-gated 2D multislice unenhanced steady-state-free precession sequences (multislice SSFP).
Sixty PV diameters in 17 consecutive patients were measured in transverse and coronal orientation with CE-MRA and multislice SSFP by two observers. Statistics to evaluate inter- and intraobserver reliability included Bland-Altman analysis and F-test.
Intraobserver limits of agreement (LAG) ranged between ±0.50 cm (transverse) and ±0.86 cm (coronal) for CE-MRA versus ±0.40 cm (transverse) and ±0.67 cm (coronal) for multislice SSFP. Interobserver agreement showed LAG ranging between ±0.59 cm (transverse) and ±0.83 cm (coronal) for CE-MRA versus ±0.34 cm (transverse) and ±0.75 cm (coronal) for multislice SSFP. Intra- and interobserver variances did not reveal significant differences between CE-MRA and multislice SSFP in any orientation (all p-values >0.05).
Multislice SSFP and CE-MRA enable comparable precision of PV diameter measurements. However, both methods reveal a wide range of intra- and interobserver agreement, which has to be thoroughly considered in clinical use.
• Unenhanced magnetic resonance imaging can now provide measurement of pulmonary vein diameters • Steady-state-free precession offers a new method of performing unenhanced MR imaging • Both unenhanced and enhanced MRI measurements show wide intra- and interobserver variation • PV diameter measurements assessed by MRI have to be interpreted with care • Nevertheless, unenhanced MRI might replace some CT examinations for pulmonary vein demonstration.
肺静脉（PV）直径评估对于房颤患者的 PV 消融的规划和随访非常重要。因此，本研究旨在评估对比增强磁共振血管造影（CE-MRA）和心电图门控 2 维多层非增强稳态自由进动序列（多层 SSFP）测量 PV 直径的观察者内和观察者间可靠性。
17 例连续患者的 60 个 PV 直径在横断和冠状位通过 CE-MRA 和多层 SSFP 由两位观察者进行测量。评价观察者内和观察者间可靠性的统计学指标包括 Bland-Altman 分析和 F 检验。
CE-MRA 观察者内的一致性界限（LAG）范围为±0.50cm（横断位）至±0.86cm（冠状位），多层 SSFP 为±0.40cm（横断位）至±0.67cm（冠状位）。CE-MRA 观察者间一致性的 LAG 范围为±0.59cm（横断位）至±0.83cm（冠状位），多层 SSFP 为±0.34cm（横断位）至±0.75cm（冠状位）。在任何方位，CE-MRA 和多层 SSFP 的观察者内和观察者间方差均无显著差异（所有 p 值均>0.05）。
多层 SSFP 和 CE-MRA 可实现 PV 直径测量的可比性精度。然而，这两种方法均显示出较大的观察者内和观察者间一致性范围，在临床应用中必须仔细考虑。
未增强磁共振成像现在可以提供肺静脉直径的测量；
稳态自由进动提供了一种新的非增强磁共振成像方法；
未增强和增强 MRI 测量均显示出广泛的观察者内和观察者间变异性；
MRI 评估的 PV 直径测量需要谨慎解释；
然而，未增强 MRI 可能会替代某些 CT 检查来显示肺静脉。
