Department of Internal Medicine/Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Int J Cardiovasc Imaging. 2020 May;36(5):899-911. doi: 10.1007/s10554-020-01775-y. Epub 2020 Feb 13.
Myocardial strain is a convenient parameter to quantify left ventricular (LV) function. Fast strain-encoding (fSENC) enables the acquisition of cardiovascular magnetic resonance images for strain-measurement within a few heartbeats during free-breathing. It is necessary to analyze inter-vendor agreement of techniques to determine strain, such as fSENC, in order to compare existing studies and plan multi-center studies. Therefore, the aim of this study was to investigate inter-vendor agreement and test-retest reproducibility of fSENC for three major MRI-vendors. fSENC-images were acquired three times in the same group of 15 healthy volunteers using 3 Tesla scanners from three different vendors: at the German Heart Institute Berlin, the Charité University Medicine Berlin-Campus Buch and the Theresien-Hospital Mannheim. Volunteers were scanned using the same imaging protocol composed of two fSENC-acquisitions, a 15-min break and another two fSENC-acquisitions. LV global longitudinal and circumferential strain (GLS, GCS) were analyzed by a trained observer (Myostrain 5.0, Myocardial Solutions) and for nine volunteers repeatedly by another observer. Inter-vendor agreement was determined using Bland-Altman analysis. Test-retest reproducibility and intra- and inter-observer reproducibility were analyzed using intraclass correlation coefficient (ICC) and coefficients of variation (CoV). Inter-vendor agreement between all three sites was good for GLS and GCS, with biases of 0.01-1.88%. Test-retest reproducibility of scans before and after the break was high, shown by ICC- and CoV values of 0.63-0.97 and 3-9% for GLS and 0.69-0.82 and 4-7% for GCS, respectively. Intra- and inter-observer reproducibility were excellent for both parameters (ICC of 0.77-0.99, CoV of 2-5%). This trial demonstrates good inter-vendor agreement and test-retest reproducibility of GLS and GCS measurements, acquired at three different scanners from three different vendors using fSENC. The results indicate that it is necessary to account for a possible bias (< 2%) when comparing strain measurements of different scanners. Technical differences between scanners, which impact inter-vendor agreement, should be further analyzed and minimized.DRKS Registration Number: 00013253.Universal Trial Number (UTN): U1111-1207-5874.
心肌应变成像为评估左心室（LV）功能的一种便捷参数。快速应变成像（fSENC）可在自由呼吸过程中于数次心跳内获取心血管磁共振图像，以实现应变测量。为了确定技术（如 fSENC）的不同供应商间的一致性，有必要对其进行分析，以便比较现有研究和规划多中心研究。因此，本研究旨在调查三种主要磁共振成像（MRI）供应商的 fSENC 的不同供应商间一致性和复测可重复性。使用来自三家不同供应商的 3T 扫描仪（德国柏林心脏研究所、柏林夏洛蒂医科大学-柏林校区和曼海姆特里萨医院），在同组 15 名健康志愿者中，三次采集 fSENC 图像。志愿者使用由两次 fSENC 采集、15 分钟的休息和另外两次 fSENC 采集组成的相同成像协议进行扫描。一名训练有素的观察者（Myostrain 5.0，Myocardial Solutions）分析 LV 整体纵向应变（GLS）和整体圆周应变（GCS），另外有 9 名志愿者由另一位观察者重复进行分析。采用 Bland-Altman 分析确定不同供应商间的一致性。使用组内相关系数（ICC）和变异系数（CoV）分析复测可重复性和观察者内及观察者间的可重复性。所有三个部位的 GLS 和 GCS 之间的不同供应商间一致性良好，偏差为 0.01-1.88%。休息前后扫描的复测可重复性高，GLS 和 GCS 的 ICC 和 CoV 值分别为 0.63-0.97 和 3-9%，0.69-0.82 和 4-7%。两个参数的观察者内和观察者间可重复性均良好（ICC 为 0.77-0.99，CoV 为 2-5%）。该试验表明，使用 fSENC，从三个不同供应商的三台不同扫描仪采集的 GLS 和 GCS 测量值具有良好的不同供应商间一致性和复测可重复性。结果表明，在比较不同扫描仪的应变测量值时，需要考虑可能存在的偏差（<2%）。应进一步分析和最小化影响不同供应商间一致性的扫描仪技术差异。DRKS 注册号：00013253。通用试验编号（UTN）：U1111-1207-5874。
