Heart and Vascular Center, Semmelweis University, Budapest, Városmajor utca 68., Budapest 1122, Hungary.
Heart and Vascular Center, Semmelweis University, Budapest, Városmajor utca 68., Budapest 1122, Hungary; Department of Sports Medicine, Semmelweis University, Budapest, Városmajor utca, 68., Budapest 1122, Hungary.
Int J Cardiol. 2023 Jun 15;381:128-134. doi: 10.1016/j.ijcard.2023.03.051. Epub 2023 Mar 23.
The quantitative differences of left and right ventricular (LV, RV) parameters of using different cardiac MRI (CMR) post-processing techniques and their clinical impact are less studied. We aimed to assess the differences and their clinical impact between the conventional contouring (CC) and the threshold-based (TB) methods using 70% and 50% thresholds in different hypertrabeculated conditions.
This retrospective study included 30 dilated cardiomyopathy, 30 left ventricular non-compaction (LVNC), 30 arrhythmogenic cardiomyopathy patients, 30 healthy athletes and 30 healthy volunteers. All participants underwent CMR imaging on 1.5 T. Cine sequences were used to derive measures of the cardiac volumes, function, total muscle mass (TMi) and trabeculae and papillary muscle mass (TPMi) using CC and TB segmentation methods.
Comparing the CC and the 70% and 50% threshold TB methods, the LV and RV volumes were significantly lower, the ejection fraction (EF) and the TMi were significantly higher with the TB methods. Between the two threshold setups, only TPMi was significantly higher with the 70% threshold. Regarding the clinical benefits, the LVNC was the only group in whom all the diagnostic and therapeutic decisions and risk stratification were influenced using the TB method. Diagnostic changes occurred in three-quarters of the population, and all the cardiomyopathy groups were affected regarding the decision-making about pharmaco- and device therapy.
Using the TB method, only TPMi was significantly higher with the 70% threshold than the 50% setup, and both of them differed significantly from the CC technique, with relevant clinical impacts in all patient groups.
使用不同心脏 MRI（CMR）后处理技术的左、右心室（LV、RV）参数的定量差异及其临床影响研究较少。我们旨在评估在不同心肌小梁化条件下，使用 70%和 50%阈值的常规轮廓（CC）和基于阈值（TB）方法的差异及其临床影响。
这项回顾性研究纳入了 30 例扩张型心肌病患者、30 例左心室心肌致密化不全（LVNC）患者、30 例致心律失常性心肌病患者、30 名健康运动员和 30 名健康志愿者。所有参与者均在 1.5T 上进行 CMR 成像。使用 CC 和 TB 分割方法，从电影序列中得出心脏容积、功能、总心肌质量（TMi）和小梁及乳头肌质量（TPMi）的测量值。
与 CC 方法相比，TB 方法的 LV 和 RV 容积显著降低，射血分数（EF）和 TMi 显著升高。在两种阈值设置中，只有 TPMi 在 70%阈值下显著升高。就临床获益而言，只有 LVNC 组的所有诊断和治疗决策以及风险分层都受到 TB 方法的影响。诊断变化发生在四分之三的人群中，所有心肌病组在药物和器械治疗的决策方面都受到影响。
在使用 TB 方法时，只有在 70%阈值下 TPMi 显著高于 50%阈值，且两者均与 CC 技术显著不同，所有患者组均存在相关的临床影响。
