心脏多频磁共振弹性成像在评估左心室僵硬度和黏度方面的可重复性
Reproducibility of Cardiac Multifrequency MR Elastography in Assessing Left Ventricular Stiffness and Viscosity.
作者信息
Castelein Johannes, Duus Amanda S, Bække Pernille S, Sack Ingolf, Anders Matthias S, Kettless Karen, Hansen Adam E, Dierckx Rudi A J O, De Backer Ole, Vejlstrup Niels G, Lund Morten A V, Borra Ronald J H
机构信息
Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands.
Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
出版信息
J Magn Reson Imaging. 2025 May;61(5):2146-2154. doi: 10.1002/jmri.29640. Epub 2024 Oct 25.
BACKGROUND
Cardiac magnetic resonance elastography (MRE) shows promise in assessing the mechanofunctional properties of the heart but faces clinical challenges, mainly synchronization with cardiac cycle, breathing, and external harmonic stimulation.
PURPOSE
To determine the reproducibility of in vivo cardiac multifrequency MRE (MMRE) for assessing diastolic left ventricular (LV) stiffness and viscosity.
STUDY TYPE
Prospective.
SUBJECTS
This single-center study included a total of 28 participants (mean age, 56.6 ± 23.0 years; 16 male) consisting of randomly selected healthy participants (mean age, 44.6 ± 20.1 years; 9 male) and patients with aortic stenosis (mean age, 78.3 ± 3.8 years; 7 male).
FIELD STRENGTH/SEQUENCE: 3 T, 3D multifrequency MRE with a single-shot spin-echo planar imaging sequence.
ASSESSMENT
Each participant underwent two cardiac MMRE examinations on the same day. Full 3D wave fields were acquired in diastole at frequencies of 80, 90, and 100 Hz during a total of three breath-holds. Shear wave speed (SWS) and penetration rate (PR) were reconstructed as a surrogate for tissue stiffness and inverse viscous loss. Epicardial and endocardial ROIs were manually drawn by two independent readers to segment the LV myocardium.
STATISTICAL TESTS
Shapiro-Wilk test, Bland-Altman analysis and intraclass correlation coefficient (ICC). P-value <0.05 were considered statistically significant.
RESULTS
Bland-Altman analyses and intraclass correlation coefficients (ICC = 0.96 for myocardial stiffness and ICC = 0.93 for viscosity) indicated near-perfect test-retest repeatability among examinations on the same day. The mean SWS for scan and re-scan diastolic LV myocardium were 2.42 ± 0.24 m/s and 2.39 ± 0.23 m/s; the mean PR were 1.24 ± 0.17 m/s and 1.22 ± 0.14 m/s. Inter-reader variability showed good to excellent agreement for myocardial stiffness (ICC = 0.92) and viscosity (ICC = 0.85).
DATA CONCLUSION
Cardiac MMRE is a promising and reproducible method for noninvasive assessment of diastolic LV stiffness and viscosity.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY: 1.
背景
心脏磁共振弹性成像（MRE）在评估心脏机械功能特性方面显示出前景，但面临临床挑战，主要是与心动周期、呼吸和外部谐波刺激同步。
目的
确定用于评估舒张期左心室（LV）僵硬度和黏度的体内心脏多频MRE（MMRE）的可重复性。
研究类型
前瞻性研究。
研究对象
这项单中心研究共纳入28名参与者（平均年龄56.6±23.0岁；16名男性），包括随机选择的健康参与者（平均年龄44.6±20.1岁；9名男性）和主动脉瓣狭窄患者（平均年龄78.3±3.8岁；7名男性）。
场强/序列：3T，采用单次激发自旋回波平面成像序列的3D多频MRE。
评估
每位参与者在同一天接受两次心脏MMRE检查。在总共三次屏气期间，于舒张期以80、90和100Hz的频率采集完整的3D波场。重建剪切波速度（SWS）和穿透率（PR）作为组织僵硬度和反向黏滞损耗的替代指标。由两名独立的阅片者手动绘制心外膜和心内膜感兴趣区（ROI）以分割左心室心肌。
统计检验
Shapiro-Wilk检验、Bland-Altman分析和组内相关系数（ICC）。P值<0.05被认为具有统计学意义。
结果
Bland-Altman分析和组内相关系数（心肌僵硬度的ICC = 0.96，黏度的ICC = 0.93）表明同一天检查之间具有近乎完美的重测重复性。扫描和重新扫描舒张期左心室心肌的平均SWS分别为2.42±0.24m/s和2.39±0.23m/s；平均PR分别为1.24±0.17m/s和1.22±0.14m/s。阅片者间变异性显示心肌僵硬度（ICC = 0.92）和黏度（ICC = 0.85）具有良好至极好的一致性。
数据结论
心脏MMRE是一种用于无创评估舒张期左心室僵硬度和黏度的有前景且可重复的方法。
证据水平
2 技术效能：1。
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