Department of Radiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
J Cardiovasc Magn Reson. 2020 Dec 7;22(1):83. doi: 10.1186/s12968-020-00684-2.
Several cardiovascular magnetic resonance (CMR) techniques can measure myocardial strain and torsion with high accuracy. The purpose of this study was to compare displacement encoding with stimulated echoes (DENSE), tagging and feature tracking (FT) for measuring circumferential and radial myocardial strain and myocardial torsion in order to assess myocardial function and infarct scar burden both at a global and at a segmental level.
116 patients with a high likelihood of coronary artery disease (European SCORE > 15%) underwent CMR examination including cine images, tagging, DENSE and late gadolinium enhancement (LGE) in the short axis direction. In total, 97 patients had signs of myocardial disease and 19 had no abnormalities in terms of left ventricular (LV) wall mass index, LV ejection fraction, wall motion, LGE or a history of myocardial infarction. Thirty-four patients had myocardial infarct scar with a transmural LGE extent (transmurality) that exceeded 50% of the wall thickness in at least one segment. Global circumferential strain (GCS) and global radial strain (GRS) was analyzed using FT of cine loops, deformation of tag lines or DENSE displacement.
DENSE and tagging both showed high sensitivity (82% and 71%) at a specificity of 80% for the detection of segments with > 50% LGE transmurality, and receiver operating characteristics (ROC) analysis showed significantly higher area under the curve-values (AUC) for DENSE (0.87) than for tagging (0.83, p < 0.001) and FT (0.66, p = 0.003). GCS correlated with global LGE when determined with DENSE (r = 0.41), tagging (r = 0.37) and FT (r = 0.15). GRS had a low but significant negative correlation with LGE; DENSE r = - 0.10, FT r = - 0.07 and tagging r = - 0.16. Torsion from DENSE and tagging had a weak correlation (- 0.20 and - 0.22 respectively) with global LGE.
Circumferential strain from DENSE detected segments with > 50% scar with a higher AUC than strain determined from tagging and FT at a segmental level. GCS and torsion computed from DENSE and tagging showed similar correlation with global scar size, while when computed from FT, the correlation was lower.
几种心血管磁共振（CMR）技术可以高精度测量心肌应变和扭转。本研究旨在比较位移编码与刺激回波（DENSE）、标记和特征跟踪（FT），以测量圆周和径向心肌应变和心肌扭转，从而评估整体和节段水平的心肌功能和梗死瘢痕负荷。
116 例高度怀疑冠心病（欧洲 SCORE>15%）的患者接受 CMR 检查，包括电影图像、标记、DENSE 和短轴方向的钆延迟增强（LGE）。共有 97 例患者存在心肌疾病迹象，19 例患者左心室（LV）壁质量指数、LV 射血分数、壁运动、LGE 或心肌梗死史无异常。34 例患者存在心肌梗死瘢痕，至少一个节段的 LGE 透壁程度（透壁性）超过 50%的壁厚度。使用电影环的 FT、标记线的变形或 DENSE 位移分析整体圆周应变（GCS）和整体径向应变（GRS）。
DENSE 和标记在特异性为 80%时，对检测>50%透壁性 LGE 的节段均具有高灵敏度（82%和 71%），ROC 分析显示 DENSE 的曲线下面积值（AUC）明显高于标记（0.83，p<0.001）和 FT（0.66，p=0.003）。当用 DENSE（r=0.41）、标记（r=0.37）和 FT（r=0.15）确定时，GCS 与整体 LGE 相关。GRS 与 LGE 呈低但显著负相关；DENSE r=-0.10，FT r=-0.07，标记 r=-0.16。DENSE 和标记的扭转与整体 LGE 相关性较弱（分别为-0.20 和-0.22）。
在节段水平上，DENSE 测量圆周应变的 AUC 高于标记和 FT，可检测>50%瘢痕的节段。DENSE 和标记计算的 GCS 和扭转与整体瘢痕大小具有相似的相关性，而 FT 计算的相关性较低。
