Backhaus Sören J, Metschies Georg, Zieschang Victoria, Erley Jennifer, Mahsa Zamani Seyedeh, Kowallick Johannes T, Lapinskas Tomas, Pieske Burkert, Lotz Joachim, Kutty Shelby, Hasenfuß Gerd, Kelle Sebastian, Schuster Andreas
Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany.
German Center for Cardiovascular Research, Göttingen, Göttingen, Germany.
Magn Reson Med. 2021 Jan;85(1):357-368. doi: 10.1002/mrm.28437. Epub 2020 Aug 27.
Myocardial feature-tracking (FT) deformation imaging is superior for risk stratification compared with volumetric approaches. Because there is no clear recommendation regarding FT postprocessing, we compared different FT-strain analyses with reference standard techniques, including tagging and strain-encoded (SENC) MRI.
Feature-tracking software from four different vendors (TomTec, Medis, Circle [CVI], and Neosoft), tagging (Segment), and fastSENC (MyoStrain) were used to determine left ventricular global circumferential strains (GCS) and longitudinal strains (GLS) in 12 healthy volunteers and 12 patients with heart failure. Variability and agreements were assessed using intraclass correlation coefficients for absolute agreement (ICCa) and consistency (ICCc) as well as Pearson correlation coefficients.
For FT-GCS, consistency was excellent comparing different FT vendors (ICCc = 0.84-0.97, r = 0.86-0.95) and in comparison to fast SENC (ICCc = 0.78-0.89, r = 0.73-0.81). FT-GCS consistency was excellent compared with tagging (ICCc = 0.79-0.85, r = 0.74-0.77) except for TomTec (ICCc = 0.68, r = 0.72). Absolute FT-GCS agreements among FT vendors were highest for CVI and Medis (ICCa = 0.96) and lowest for TomTec and Neosoft (ICCa = 0.32). Similarly, absolute FT-GCS agreements were excellent for CVI and Medis compared with both tagging and fast SENC (ICCa = 0.84-0.88), good to excellent for Neosoft (ICCa = 0.77 and 0.64), and lowest for TomTec (ICCa = 0.41 and 0.47). For FT-GLS, consistency was excellent (ICCc ≥ 0.86, r ≥ 0.76). Absolute agreements among FT vendors were excellent (ICCa = 0.91-0.93) or good to excellent for TomTec (ICCa = 0.69-0.85). Absolute agreements (ICCa) were good (CVI 0.70, Medis 0.60) and fair (TomTec 0.41, Neosoft 0.59) compared with tagging, but excellent compared with fast SENC (ICCa = 0.77-0.90).
Although absolute agreements differ depending on deformation assessment approaches, consistency and correlation are consistently high regardless of the method chosen, thus indicating reliable strain assessment. Further standardisation and introduction of uniform references is warranted for routine clinical implementation.
与容积法相比，心肌特征追踪（FT）变形成像在风险分层方面更具优势。由于关于FT后处理尚无明确建议，我们将不同的FT应变分析与包括标记和应变编码（SENC）MRI在内的参考标准技术进行了比较。
使用来自四个不同供应商（TomTec、Medis、Circle [CVI]和Neosoft）的特征追踪软件、标记（Segment）和快速SENC（MyoStrain）来确定12名健康志愿者和12名心力衰竭患者的左心室整体圆周应变（GCS）和纵向应变（GLS）。使用组内相关系数评估绝对一致性（ICCa）和一致性（ICCc）以及Pearson相关系数的变异性和一致性。
对于FT-GCS，比较不同的FT供应商时一致性极佳（ICCc = 0.84 - 0.97，r = 0.86 - 0.95），与快速SENC相比也是如此（ICCc = 0.78 - 0.89，r = 0.73 - 0.81）。与标记相比，FT-GCS一致性极佳（ICCc = 0.79 - 0.85，r = 0.74 - 0.77），TomTec除外（ICCc = 0.68，r = 0.72）。FT供应商之间的绝对FT-GCS一致性在CVI和Medis中最高（ICCa = 0.96），在TomTec和Neosoft中最低（ICCa = 0.32）。同样，与标记和快速SENC相比，CVI和Medis的绝对FT-GCS一致性极佳（ICCa = 0.84 - 0.88），Neosoft为良好至极佳（ICCa = 0.77和0.64），TomTec最低（ICCa = 0.41和0.47）。对于FT-GLS，一致性极佳（ICCc≥0.86，r≥0.76）。FT供应商之间的绝对一致性极佳（ICCa = 0.91 - 0.93），或TomTec为良好至极佳（ICCa = 0.69 - 0.85）。与标记相比，绝对一致性（ICCa）为良好（CVI 0.70，Medis 0.60）和一般（TomTec 0.41，Neosoft 0.59），但与快速SENC相比极佳（ICCa = 0.77 - 0.90）。
尽管绝对一致性因变形评估方法而异，但无论选择何种方法，一致性和相关性始终很高，从而表明应变评估可靠。对于常规临床应用，需要进一步标准化并引入统一的参考标准。
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