Furber A, Balzer P, Le Jeune J J, Rouleau F, Bienvenu P, Croué A, Lethimonnier F, Jallet P, Tadei A, Geslin P
Service de cardiologie, Centre hospitalier universitaire, Angers.
Arch Mal Coeur Vaiss. 1998 Jul;91(7):863-71.
This study describes a method of automatic border detection of the left ventricular endocardium and epicardium associating three methods of segmentation (increase of region, border detection and adaptive threshold), applicable to the evaluation of ventricular mass and volume by magnetic resonance imaging. Despite slight underestimation, the spin-echo sequence used in 9 small pigs provided a value of left ventricular mass close to that observed ex vivo (r = 0.97, SEE = 6.05 g). Clinical validation using a rapid gradient-echo sequence was undertaken and compared with manual border detection carried out by three independent, trained operators. The study population included healthy subjects and patients with global or segmental left ventricular dysfunction with or without ventricular deformation. The correlations between automatic and manual detection were satisfactory both for calculation of left ventricular mass (r = 0.93, SEE = 13 g) and measurement of surfaces (r = 0.91, SEE = 1.4 cm2). The concordance of the two methods was confirmed by the Bland and Altman test. Cardiac magnetic resonance imaging may provide accurate and reproducible measurements of left ventricular mass within acceptable acquisition and image processing times for routine use. Although the clinical value of such a method is accepted both for establishing the prognosis and guiding management, studies of the cost/efficacy ratio should be undertaken to situate magnetic resonance imaging with respect to other non-invasive techniques of investigation of left ventricular function.
本研究描述了一种结合三种分割方法（区域增长、边界检测和自适应阈值）自动检测左心室内膜和外膜边界的方法，该方法适用于通过磁共振成像评估心室质量和容积。尽管存在轻微低估，但在9只小猪中使用的自旋回波序列得出的左心室质量值与体外观察值相近（r = 0.97，标准误差估计值 = 6.05 g）。使用快速梯度回波序列进行了临床验证，并与三名经过独立培训的操作人员进行的手动边界检测进行了比较。研究人群包括健康受试者以及有或无心室变形的整体或节段性左心室功能障碍患者。对于左心室质量计算（r = 0.93，标准误差估计值 = 13 g）和表面积测量（r = 0.91，标准误差估计值 = 1.4 cm²），自动检测与手动检测之间的相关性均令人满意。Bland和Altman检验证实了两种方法的一致性。心脏磁共振成像可在可接受的采集和图像处理时间内为常规使用提供准确且可重复的左心室质量测量。尽管这种方法的临床价值在确定预后和指导治疗方面均得到认可，但仍应开展成本/效益比研究，以便将磁共振成像与其他左心室功能无创检测技术进行比较。
