Demeyere Matthieu, Dubourg Benjamin, Delacour David, Bejar Sofiane, Michelin Paul, Dacher Jean-Nicolas
Department of Radiology, Cardiac MR/CT Unit, Rouen University Hospital, 37 Boulevard Gambetta, 76000, Rouen, France.
Normandie Univ, UNIROUEN, INSERM U1096, 22 Boulevard Gambetta, 76000, Rouen, France.
Int J Cardiovasc Imaging. 2020 Nov;36(11):2255-2263. doi: 10.1007/s10554-020-01941-2. Epub 2020 Sep 14.
Primary objective was to evaluate by cardiac MRI the accuracy of right ventricular stroke volume (RVSV) measurement in the short-axis (SA) plane with cross-referencing of the tricuspid plane. 2D phase-contrast measurement at the main pulmonary artery (PSV) was the reference. Secondary objective was to analyze the reproducibility of RV functional parameters. In this single-center retrospective study, 41 patients (mean age 40 ± 18 years; age range 16-71 years; M/F sex ratio 51%) referred for various acquired and congenital cardiopathies underwent CMR including SA balanced steady state free precession imaging (b-SSFP). Right ventricular vertical long-axis and four chamber views were used for cross-referenced localization of the tricuspid valve. Right ventricular functional parameters were measured on three occasions by two observers using Syngo Via® (Siemens Healthineers, Erlangen, Germany). The Student t-test and Bland Altman plot were used to test for differences between RV stroke volumes derived from cine b-SSFP (RVSV) or 2D PC (PSV). Bland Altman plots, coefficient of variation (COV) and intraclass correlation coefficient (ICC) were used to evaluate intra- and inter-observer reproducibility of RVSV, RVED and RVES volumes, and RV ejection fraction. There was high correlation (r = 0.94) and no significant difference between RVSV and PSV (83 ± 20 mL vs. 81 ± 21 mL p > 0.05). Intra- (ICC: 0.95; COV: 6.2) and inter-observer reliability (ICC: 0.91; COV: 8.9) of RVSV measurements were excellent. Finally, intra- and inter-observer reproducibility was excellent for RVEF, RVEDV and RVESV. Right ventricular stroke volumes can be routinely derived from SA analysis using cross-referenced localization of the atrioventricular plane. Moreover, all right ventricular systolic function parameters are highly reproducible when using this technique.
主要目的是通过心脏磁共振成像（CMR）评估在短轴（SA）平面上，通过三尖瓣平面交叉参考测量右心室每搏输出量（RVSV）的准确性。以主肺动脉处的二维相位对比测量值（PSV）作为参考。次要目的是分析右心室功能参数的可重复性。在这项单中心回顾性研究中，41例因各种获得性和先天性心脏病前来就诊的患者（平均年龄40±18岁；年龄范围16 - 71岁；男女比例51%）接受了CMR检查，包括SA平面的平衡稳态自由进动成像（b - SSFP）。使用右心室垂直长轴和四腔心视图对三尖瓣进行交叉参考定位。两名观察者使用Syngo Via®（西门子医疗，德国埃尔朗根）在三个不同时间测量右心室功能参数。采用学生t检验和布兰德 - 奥特曼图来检验电影b - SSFP（RVSV）或二维相位对比法（PSV）得出的右心室每搏输出量之间的差异。使用布兰德 - 奥特曼图、变异系数（COV）和组内相关系数（ICC）来评估观察者内和观察者间RVSV、右心室舒张末期容积（RVED）、右心室收缩末期容积（RVES）以及右心室射血分数的可重复性。RVSV与PSV之间存在高度相关性（r = 0.94），且无显著差异（83±20 mL对81±21 mL，p>0.05）。RVSV测量的观察者内（ICC：0.95；COV：6.2）和观察者间可靠性（ICC：0.91；COV：8.9）都非常好。最后，观察者内和观察者间RVEF、RVEDV和RVESV的可重复性都非常好。右心室每搏输出量可通过使用房室平面的交叉参考定位，从SA分析中常规得出。此外，使用该技术时，所有右心室收缩功能参数都具有高度可重复性。
