压缩感知实时电影心血管磁共振成像：单次屏气下对左心室功能的准确评估
Compressed sensing real-time cine cardiovascular magnetic resonance: accurate assessment of left ventricular function in a single-breath-hold.
作者信息
Kido Tomoyuki, Kido Teruhito, Nakamura Masashi, Watanabe Kouki, Schmidt Michaela, Forman Christoph, Mochizuki Teruhito
机构信息
Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Department of Radiology, Saiseikai Matsuyama Hospital, 880-2, Yamanishi, Matsuyama, Ehime, 791-8026, Japan.
出版信息
J Cardiovasc Magn Reson. 2016 Aug 24;18(1):50. doi: 10.1186/s12968-016-0271-0.
BACKGROUND
Cardiovascular cine magnetic resonance (CMR) accelerated by compressed sensing (CS) is used to assess left ventricular (LV) function. However, it is difficult for prospective CS cine CMR to capture the complete end-diastolic phase, which can lead to underestimation of the end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF), compared to retrospective standard cine CMR. This prospective study aimed to evaluate the diagnostic quality and accuracy of single-breath-hold full cardiac cycle CS cine CMR, acquired over two heart beats, to quantify LV volume in comparison to multi-breath-hold standard cine CMR.
METHODS
Eighty-one participants underwent standard segmented breath-hold cine and CS real-time cine CMR examinations to obtain a stack of eight contiguous short-axis images with same high spatial (1.7 × 1.7 mm(2)) and temporal resolution (41 ms). Two radiologists independently performed qualitative analysis of image quality (score, 1 [i.e., "nondiagnostic"] to 5 [i.e., "excellent"]) and quantitative analysis of the LV volume measurements.
RESULTS
The total examination time was 113 ± 7 s for standard cine CMR and 24 ± 4 s for CS cine CMR (p < 0.0001). The CS cine image quality was slightly lower than standard cine (4.8 ± 0.5 for standard vs. 4.4 ± 0.5 for CS; p < 0.0001). However, all image quality scores for CS cine were above 4 (i.e., good). No significant differences existed between standard and CS cine MR for all quantitative LV measurements. The mean differences with 95 % confidence interval (CI), based on Bland-Altman analysis, were 1.3 mL (95 % CI, -14.6 - 17.2) for LV end-diastolic volume, 0.2 mL (95 % CI, -9.8 to10.3) for LV end-systolic volume, 1.1 mL (95 % CI, -10.5 to 12.7) for LV stroke volume, 1.0 g (95 % CI, -11.2 to 13.3) for LV mass, and 0.4 % (95 % CI, -4.8 - 5.6) for LV ejection fraction. The interobserver and intraobserver variability for CS cine MR ranged from -4.8 - 1.6 % and from -7.3 - 9.3 %, respectively, with slopes of the regressions ranging 0.88-1.0 and 0.86-1.03, respectively.
CONCLUSIONS
Single-breath-hold full cardiac cycle CS real-time cine CMR could evaluate LV volume with excellent accuracy. It may replace multi-breath-hold standard cine CMR.
背景
通过压缩感知（CS）加速的心血管电影磁共振成像（CMR）用于评估左心室（LV）功能。然而，与回顾性标准电影CMR相比，前瞻性CS电影CMR难以捕捉完整的舒张末期，这可能导致舒张末期容积（EDV）、每搏输出量（SV）和射血分数（EF）的低估。这项前瞻性研究旨在评估在两个心跳周期内采集的单屏气全心动周期CS电影CMR与多屏气标准电影CMR相比，用于量化LV容积的诊断质量和准确性。
方法
81名参与者接受了标准分段屏气电影和CS实时电影CMR检查，以获得一叠8个连续的短轴图像，具有相同的高空间分辨率（1.7×1.7mm²）和时间分辨率（41ms）。两名放射科医生独立对图像质量进行定性分析（评分，1[即“无法诊断”]至5[即“优秀”]），并对LV容积测量进行定量分析。
结果
标准电影CMR的总检查时间为113±7秒，CS电影CMR为24±4秒（p<0.0001）。CS电影图像质量略低于标准电影（标准为4.8±0.5，CS为4.4±0.5；p<0.0001）。然而，CS电影的所有图像质量评分均高于4（即良好）。标准和CS电影MR在所有定量LV测量方面均无显著差异。基于Bland-Altman分析，95%置信区间（CI）的平均差异为：LV舒张末期容积为1.3mL（95%CI，-14.6至17.2），LV收缩末期容积为0.2mL（95%CI，-9.8至10.3），LV每搏输出量为1.1mL（95%CI，-10.5至12.7），LV质量为1.0g（95%CI，-11.2至13.3），LV射血分数为0.4%（95%CI，-4.8至5.6）。CS电影MR的观察者间和观察者内变异性分别为-4.8至1.6%和-7.3至9.3%，回归斜率分别为0.88至1.0和0.86至1.03。
结论
单屏气全心动周期CS实时电影CMR能够以优异的准确性评估LV容积。它可能会取代多屏气标准电影CMR。
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