Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.
Integrative Biomedical Research, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.
Radiol Med. 2018 May;123(5):331-337. doi: 10.1007/s11547-017-0851-6. Epub 2018 Jan 22.
To validate a blood-threshold (BT) segmentation software for cardiac magnetic resonance (CMR) cine images in patients with functional univentricular heart (FUH).
We evaluated retrospectively 44 FUH patients aged 25 ± 8 years (mean ± standard deviation). For each patient, the epicardial contour of the single ventricle was manually segmented on cine images by two readers and an automated BT algorithm was independently applied to calculate end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and cardiac mass (CM). Aortic flow analysis (AFA) was performed on through-plane images to obtain forward volumes and used as a benchmark. Reproducibility was tested in a subgroup of 24 randomly selected patients. Wilcoxon, Spearman, and Bland-Altman statistics were used.
No significant difference was found between SV (median 57.7 ml; interquartile range 47.9-75.6) and aortic forward flow (57.4 ml; 48.9-80.4) (p = 0.123), with a high correlation (r = 0.789, p < 0.001). Intra-reader reproducibility was 86% for SV segmentation, and 96% for AFA. Inter-reader reproducibility was 85 and 96%, respectively.
The BT segmentation provided an accurate and reproducible assessment of heart function in FUH patients.
验证一种用于功能性单心室（FUH）患者心脏磁共振（CMR）电影图像的血容量（BT）分割软件。
我们回顾性评估了 44 例 FUH 患者，年龄 25 ± 8 岁（均值 ± 标准差）。对每位患者，由两名读者手动在电影图像上分割单个心室的心外膜轮廓，并独立应用自动 BT 算法计算舒张末期容积（EDV）、收缩末期容积（ESV）、心排量（SV）、射血分数（EF）和心脏质量（CM）。通过平面图像进行主动脉流量分析（AFA）以获得正向容积并作为基准。在随机选择的 24 例患者亚组中测试了重复性。使用 Wilcoxon、Spearman 和 Bland-Altman 统计。
SV（中位数 57.7ml；四分位间距 47.9-75.6）与主动脉正向流量（57.4ml；48.9-80.4）之间无显著差异（p=0.123），相关性高（r=0.789，p<0.001）。SV 分割的读者内重复性为 86%，AFA 为 96%。读者间重复性分别为 85%和 96%。
BT 分割为 FUH 患者的心脏功能提供了准确且可重复的评估。
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