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二叶式主动脉瓣患者的左心室整体纵向应变:计算机断层扫描、4D 流心血管磁共振和斑点追踪超声心动图的头对头比较。

Left ventricular global longitudinal strain in bicupsid aortic valve patients: head-to-head comparison between computed tomography, 4D flow cardiovascular magnetic resonance and speckle-tracking echocardiography.

机构信息

Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.

Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

出版信息

Int J Cardiovasc Imaging. 2020 Sep;36(9):1771-1780. doi: 10.1007/s10554-020-01883-9. Epub 2020 May 25.

Abstract

Left ventricular global longitudinal strain (LVGLS) analysis is a sensitive measurement of myocardial deformation most often done using speckle-tracking transthoracic echocardiography (TTE). We propose a novel approach to measure LVGLS using feature-tracking software on the magnitude dataset of 4D flow cardiovascular magnetic resonance (CMR) and compare it to dynamic computed tomography (CT) and speckle tracking TTE derived measurements. In this prospective cohort study 59 consecutive adult patients with a bicuspid aortic valve (BAV) were included. The study protocol consisted of TTE, CT, and CMR on the same day. Image analysis was done using dedicated feature-tracking (4D flow CMR and CT) and speckle-tracking (TTE) software, on apical 2-, 3-, and 4-chamber long-axis multiplanar reconstructions (4D flow CMR and CT) or standard apical 2-, 3-, and 4-chamber acquisitions (TTE). CMR and CT GLS analysis was feasible in all patients. Good correlations were observed for GLS measured by CMR (- 21 ± 3%) and CT (- 20 ± 3%) versus TTE (- 20 ± 3%, Pearson's r: 0.67 and 0.65, p < 0.001). CMR also correlated well with CT (Pearson's r 0.62, p < 0.001). The inter-observer analysis showed moderate to good reproducibility of GLS measurement by CMR, CT and TTE (Pearsons's r: 0.51, 0.77, 0.70 respectively; p < 0.05). Additionally, ejection fraction (EF), end-diastolic and end-systolic volume measurements (EDV and ESV) correlated well between all modalities (Pearson's r > 0.61, p < 0.001). Feature-tracking GLS analysis is feasible using the magnitude images acquired with 4D flow CMR. GLS measurement by CMR correlates well with CT and speckle-tracking 2D TTE. GLS analysis on 4D flow CMR allows for an integrative approach, integrating flow and functional data in a single sequence. Not applicable, observational study.

摘要

左心室整体纵向应变(LVGLS)分析是一种测量心肌变形的敏感方法,最常用于斑点追踪经胸超声心动图(TTE)。我们提出了一种使用四维血流心血管磁共振(CMR)的幅度数据集上的特征追踪软件来测量 LVGLS 的新方法,并将其与动态计算机断层扫描(CT)和斑点追踪 TTE 衍生的测量方法进行了比较。在这项前瞻性队列研究中,纳入了 59 例连续的二叶式主动脉瓣(BAV)成人患者。研究方案包括当天进行 TTE、CT 和 CMR。使用专用的特征追踪(4D 流 CMR 和 CT)和斑点追踪(TTE)软件对心尖 2、3 和 4 腔长轴多平面重建(4D 流 CMR 和 CT)或标准心尖 2、3 和 4 腔采集(TTE)进行图像分析。所有患者均可行 CMR 和 CT GLS 分析。在 CMR(-21±3%)和 CT(-20±3%)与 TTE(-20±3%)测量的 GLS 中观察到良好的相关性(Pearson's r:0.67 和 0.65,p<0.001)。CMR 与 CT 也有很好的相关性(Pearson's r 0.62,p<0.001)。观察者间分析显示,CMR、CT 和 TTE 测量的 GLS 具有中等至良好的可重复性(Pearsons's r:0.51、0.77、0.70;p<0.05)。此外,射血分数(EF)、舒张末期和收缩末期容积(EDV 和 ESV)在所有模态之间相关性良好(Pearson's r>0.61,p<0.001)。使用 4D 流 CMR 获得的幅度图像可以进行特征追踪 GLS 分析。CMR 测量的 GLS 与 CT 和斑点追踪二维 TTE 相关性良好。4D 流 CMR 上的 GLS 分析允许采用综合方法,在单个序列中整合流量和功能数据。不适用,观察性研究。

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