Department of Imaging and Pathology, KU Leuven - University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, y CIBERCV, Salamanca, Spain.
Eur Radiol. 2018 Dec;28(12):5137-5147. doi: 10.1007/s00330-018-5538-4. Epub 2018 Jun 5.
To compare the reproducibility of cardiovascular magnetic resonance feature-tracking (CMR-FT) packages to assess global left ventricular (LV) myocardial strain.
In 45 subjects (i.e. 15 controls, 15 acute myocardial infarction, 15 dilated cardiomyopathy patients), we determined inter-vendor, inter-observer (two readers) and intra-observer reproducibility of peak systolic global radial, circumferential and longitudinal strain (GRS, GCS and GLS, respectively) comparing four commercially available software packages. Differences between vendors were assessed with analysis of variance (ANOVA), between observers and readings with intraclass correlation coefficient (ICC) and coefficient of variation (CV).
The normalised end-diastolic volume was 91, 77 and 119 ml/m (median, Q1, Q3) and ejection fraction was 41 ± 14%, range 12-67%. Global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS) values were 13.9% ± 5.4% (3.9-23.8%), 12.2% ± 5.8% (1.0-25.1%) and 32.0% ± 14.7 (3.6-67.8%), respectively. ANOVA showed significant differences between vendors for GRS (p < 0.001) and GLS (p = 0.018), not for GCS (p = 0.379). No significant bias was found for both intra- and inter-observer variability. The ICC for inter- and intra-observer reproducibility ranged 0.828-0.991 and 0.902-0.997, respectively. The CV, however, ranged considerably, i.e. 4.0-28.8% and 2.8- 27.7% for inter- and intra-observer reproducibility, respectively. In particular, for GRS differences in CV values between vendors were large, i.e. 5.2-28.8% and 2.8-27.7%, for inter- and intra-observer reproducibility, respectively.
In a cohort of subjects with a wide range of cardiac performances, GRS and GLS values are not interchangeable between vendors. Moreover, although intra- and inter-observer reproducibility amongst vendors is excellent, some vendors encounter problems to reproducibly measure global radial strain.
• Different software packages are currently available for myocardial strain assessment using routinely acquired cine CMR images. • Global myocardial strain values are not interchangeable between vendors for global longitudinal and global radial strain. • Inter- and intra-observer reproducibility for global strain assessment is excellent. However, some vendors encounter problems to reproducibly measure global radial strain.
比较心血管磁共振特征追踪（CMR-FT）包评估整体左心室（LV）心肌应变的可重复性。
在 45 名受试者（即 15 名对照、15 名急性心肌梗死、15 名扩张型心肌病患者）中，我们比较了四种商业上可用的软件包，以评估峰值收缩期整体径向、周向和纵向应变（GRS、GCS 和 GLS）的供应商间、观察者间和观察者内的可重复性。使用方差分析（ANOVA）评估供应商之间的差异，使用组内相关系数（ICC）和变异系数（CV）评估观察者之间和读数之间的差异。
正常舒张末期容积为 91、77 和 119ml/m（中位数、Q1、Q3），射血分数为 41±14%，范围为 12-67%。整体纵向应变（GLS）、整体周向应变（GCS）和整体径向应变（GRS）值分别为 13.9%±5.4%（3.9-23.8%）、12.2%±5.8%（1.0-25.1%）和 32.0%±14.7%（3.6-67.8%）。ANOVA 显示，供应商之间在 GRS（p<0.001）和 GLS（p=0.018）方面存在显著差异，但在 GCS（p=0.379）方面无显著差异。在观察者内和观察者间的可重复性方面，均未发现明显的偏差。观察者间和观察者内的 ICC 分别为 0.828-0.991 和 0.902-0.997。然而，CV 的范围相当大，即观察者间和观察者内的可重复性分别为 4.0-28.8%和 2.8-27.7%。特别是，供应商之间 GRS 的 CV 值差异较大，观察者间和观察者内的可重复性分别为 5.2-28.8%和 2.8-27.7%。
在一组具有广泛心脏功能的受试者中，GRS 和 GLS 值在供应商之间不可互换。此外，尽管供应商之间的观察者内和观察者间的可重复性很好，但一些供应商在重复性测量整体径向应变方面存在问题。
目前有多种软件包可用于使用常规采集的电影 CMR 图像评估心肌应变。
对于整体纵向应变和整体径向应变，供应商之间的整体心肌应变值不可互换。
整体应变评估的观察者内和观察者间的可重复性很好。然而，一些供应商在重复性测量整体径向应变方面存在问题。
