Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, 1200, Woluwe St. Lambert, Belgium.
Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
J Cardiovasc Magn Reson. 2021 May 13;23(1):54. doi: 10.1186/s12968-021-00742-3.
Cardiovascular magnetic resonance (CMR) 2D feature tracking (FT) left ventricular (LV) myocardial strain has seen widespread use to characterize myocardial deformation. Yet, validation of CMR FT measurements remains scarce, particularly for regional strain. Therefore, we aimed to perform intervendor comparison of 3 different FT software against tagging.
In 61 subjects (18 healthy subjects, 18 patients with chronic myocardial infarction, 15 with dilated cardiomyopathy, and 10 with LV hypertrophy due to hypertrophic cardiomyopathy or aortic stenosis) were prospectively compared global (G) and regional transmural peak-systolic Lagrangian longitudinal (LS), circumferential (CS) and radial strains (RS) by 3 FT software (cvi42, Segment, and Tomtec) among each other and with tagging at 3T. We also evaluated the ability of regional LS, CS, and RS by different FT software vs tagging to identify late gadolinium enhancement (LGE) in the 18 infarct patients.
GLS and GCS by all 3 software had an excellent agreement among each other (ICC = 0.94-0.98 for GLS and ICC = 0.96-0.98 for GCS respectively) and against tagging (ICC = 0.92-0.94 for GLS and ICC = 0.88-0.91 for GCS respectively), while GRS showed inconsistent agreement between vendors (ICC 0.10-0.81). For regional LS, the agreement was good (ICC = 0.68) between 2 vendors but less vs the 3 (ICC 0.50-0.59) and moderate to poor (ICC 0.44-0.47) between all three FT software and tagging. Also, for regional CS agreement between 2 software was higher (ICC = 0.80) than against the 3rd (ICC = 0.58-0.60), and both better agreed with tagging (ICC = 0.70-0.72) than the 3rd (ICC = 0.57). Regional RS had more variation in the agreement between methods ranging from good (ICC = 0.75) to poor (ICC = 0.05). Finally, the accuracy of scar detection by regional strains differed among the 3 FT software. While the accuracy of regional LS was similar, CS by one software was less accurate (AUC 0.68) than tagging (AUC 0.80, p < 0.006) and RS less accurate (AUC 0.578) than the other two (AUC 0.76 and 0.73, p < 0.02) to discriminate segments with LGE.
We confirm good agreement of CMR FT and little intervendor difference for GLS and GCS evaluation, with variable agreement for GRS. For regional strain evaluation, intervendor difference was larger, especially for RS, and the diagnostic performance varied more substantially among different vendors for regional strain analysis.
心血管磁共振（CMR）二维特征追踪（FT）左心室（LV）心肌应变已广泛用于描述心肌变形。然而，CMR FT 测量的验证仍然很少，特别是对于区域性应变。因此，我们旨在对 3 种不同的 FT 软件与标记法进行供应商间比较。
在 61 例受试者（18 例健康受试者、18 例慢性心肌梗死患者、15 例扩张型心肌病患者和 10 例因肥厚型心肌病或主动脉瓣狭窄导致的 LV 肥厚患者）中，我们前瞻性地比较了 3 种 FT 软件（cvi42、Segment 和 Tomtec）之间以及与 3T 标记法之间的整体（G）和节段性透壁峰值收缩期拉格朗日纵向（LS）、周向（CS）和径向应变（RS）。我们还评估了不同 FT 软件的节段性 LS、CS 和 RS 与标记法相比识别 18 例梗死患者中的延迟钆增强（LGE）的能力。
所有 3 种软件的 GLS 和 GCS 之间具有很好的一致性（GLS 的 ICC 为 0.94-0.98，GCS 的 ICC 为 0.96-0.98），与标记法的一致性也很好（GLS 的 ICC 为 0.92-0.94，GCS 的 ICC 为 0.88-0.91），而 GRS 之间的一致性不一致（ICC 0.10-0.81）。对于节段性 LS，两种供应商之间的一致性较好（ICC=0.68），但与三种供应商之间的一致性较低（ICC=0.50-0.59），与三种 FT 软件和标记法的一致性为中度至较差（ICC=0.44-0.47）。此外，两种软件之间的节段性 CS 一致性较高（ICC=0.80），而与第三种软件的一致性较低（ICC=0.58-0.60），与第三种软件的一致性均优于标记法（ICC=0.70-0.72）。节段性 RS 的方法之间的一致性变化较大，从较好（ICC=0.75）到较差（ICC=0.05）。最后，不同 FT 软件的节段性应变检测的准确性存在差异。虽然节段性 LS 的准确性相似，但一种软件的 CS 准确性（AUC 为 0.68）低于标记法（AUC 为 0.80，p<0.006），RS 准确性（AUC 为 0.578）低于其他两种（AUC 为 0.76 和 0.73，p<0.02），以区分有 LGE 的节段。
我们证实了 CMR FT 的良好一致性和 GLS 和 GCS 评估的很少供应商差异，而 GRS 的一致性则存在差异。对于节段性应变评估，供应商间的差异较大，尤其是 RS，不同供应商的节段性应变分析的诊断性能差异更大。
