应用 MRI 特征追踪技术对修复 Fontan 患者和正常儿童志愿者进行二维和三维应变测量的定量比较。
Quantitative comparison of two-dimensional and three-dimensional strain measurement using MRI feature tracking in repair Fontan patients and normal child volunteers.
机构信息
Diagnostic Imaging Center of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People's Republic of China.
Radiology, University of Wisconsin-Madison, Madison, WI, USA.
出版信息
BMC Med Imaging. 2020 Jan 28;20(1):8. doi: 10.1186/s12880-020-0413-6.
BACKGROUND
The accuracy of 2D and 3D strain analyses was evaluated by comparing strain and cardiac function parameters in Fontan repair patients and normal child volunteers.
METHODS
We retrospectively enrolled 32 patients with Fontan circulation and 32 child volunteers who had undergone clinical cardiac magnetic resonance (CMR) assessment of the dominant ventricle with a 1.5-Tesla MRI scanner. Global and regional strain (2D and 3D) of the dominant ventricle in both groups was assessed using CMR feature-tracking. Correlations between cardiac function and strain data were assessed using Pearson's correlation coefficient values. The intraclass correlation coefficient (ICC) and coefficient of variation (CoV) were determined to evaluate repeatability and agreement.
RESULTS
The 2D GLS showed significant differences between the Fontan repair patients and volunteers (- 16.49 ± 5.00 vs. -19.49 ± 2.03; p = 0.002). The 2D GRS and 2D GCS showed no significant differences between two groups. 2D GRS: 38.96 ± 14.48 vs. 37.46 ± 7.77; 2D GCS: - 17.64 ± 5.00 vs. -16.89 ± 2.96, respectively; p > 0.05). The 3D global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) showed significant differences between the Fontan repair patients and volunteers (3D GRS: 36.35 ± 16.72 vs. 44.96 ± 9.98; 3D GLS: - 8.86 ± 6.84 vs. -13.67 ± 2.44; 3D GCS: - 13.70 ± 7.84 vs. -18.01 ± 1.78; p < 0.05, respectively). The ejection fraction (EF) and 3D GCS were significantly associated (r = - 0.491, p = 0.004). The 3D GCS showed correlations with the indexed end-diastolic volume (EDV) (r = 0.523, p = 0.002) and indexed end-systolic volume (ESV) (r = 0.602, p < 0.001). 3D strain showed good reproducibility, with GCS showing the best inter-observer agreement (ICC = 0.87 and CoV = 5.15), followed by GLS (ICC = 0.84 and CoV = 5.36).
CONCLUSIONS
3D GCS is feasible, highly reproducible, and strongly correlated with conventional cardiac function measures. 3D GCS assessments may be useful for monitoring abnormal myocardial motion in patients with Fontan circulation.
背景
通过比较 Fontan 修复患者和正常儿童志愿者的应变和心脏功能参数，评估了 2D 和 3D 应变分析的准确性。
方法
我们回顾性纳入了 32 例 Fontan 循环患者和 32 名接受过 1.5T MRI 扫描仪临床心脏磁共振（CMR）评估优势心室的儿童志愿者。使用 CMR 特征追踪法评估两组优势心室的整体和局部应变（2D 和 3D）。使用 Pearson 相关系数值评估心脏功能和应变数据之间的相关性。使用组内相关系数（ICC）和变异系数（CoV）来评估重复性和一致性。
结果
2D GLS 在 Fontan 修复患者和志愿者之间存在显著差异（-16.49±5.00 与-19.49±2.03；p=0.002）。2D GRS 和 2D GCS 在两组之间无显著差异。2D GRS：38.96±14.48 与 37.46±7.77；2D GCS：-17.64±5.00 与-16.89±2.96，分别；p>0.05）。3D 整体径向应变（GRS）、整体周向应变（GCS）和整体纵向应变（GLS）在 Fontan 修复患者和志愿者之间存在显著差异（3D GRS：36.35±16.72 与 44.96±9.98；3D GLS：-8.86±6.84 与-13.67±2.44；3D GCS：-13.70±7.84 与-18.01±1.78；p<0.05）。射血分数（EF）和 3D GCS 呈显著相关性（r=-0.491，p=0.004）。3D GCS 与指数末舒张容积（EDV）（r=0.523，p=0.002）和指数末收缩容积（ESV）（r=0.602，p<0.001）呈正相关。3D 应变具有良好的可重复性，其中 GCS 具有最佳的观察者间一致性（ICC=0.87，CoV=5.15），其次是 GLS（ICC=0.84，CoV=5.36）。
结论
3D GCS 是可行的、高度可重复的，与传统心脏功能测量具有很强的相关性。3D GCS 评估可能有助于监测 Fontan 循环患者异常的心肌运动。
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