Functional measurements based on feature tracking of cine magnetic resonance images identify left ventricular segments with myocardial scar

被引:103
作者
Maret, Eva [1 ,2 ]
Todt, Tim [3 ]
Brudin, Lars [3 ,4 ]
Nylander, Eva [2 ]
Swahn, Eva [3 ,5 ]
Ohlsson, Jan L. [1 ]
Engvall, Jan E. [2 ,5 ]
机构
[1] Ryhov Cty Hosp, Dept Clin Physiol, SE-55185 Jonkoping, Sweden
[2] Linkoping Univ, Ctr Med Image Sci & Visualizat, SE-58185 Linkoping, Sweden
[3] Linkoping Univ Hosp, Div Cardiovasc Med, Dept Med & Hlth Sci, SE-58185 Jonkoping, Sweden
[4] Kalmar Cty Hosp, Dept Clin Physiol, SE-39185 Kalmar, Sweden
[5] Linkoping Univ Hosp, Dept Med & Hlth Sci CVM Clin Physiol, SE-55185 Jonkoping, Sweden
基金
瑞典研究理事会; 英国医学研究理事会;
关键词
CORONARY-ARTERY-DISEASE; LONGITUDINAL STRAIN; INFARCT SIZE; TISSUE DOPPLER; HEART; DYSFUNCTION; QUANTIFICATION; MORTALITY; ECHOCARDIOGRAPHY; REPRODUCIBILITY;
D O I
10.1186/1476-7120-7-53
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The aim of the study was to perform a feature tracking analysis on cine magnetic resonance (MR) images to elucidate if functional measurements of the motion of the left ventricular wall may detect scar defined with gadolinium enhanced MR. Myocardial contraction can be measured in terms of the velocity, displacement and local deformation (strain) of a particular myocardial segment. Contraction of the myocardial wall will be reduced in the presence of scar and as a consequence of reduced myocardial blood flow. Methods: Thirty patients (3 women and 27 men) were selected based on the presence or absence of extensive scar in the anteroseptal area of the left ventricle. The patients were investigated in stable clinical condition, 4-8 weeks post ST-elevation myocardial infarction treated with percutaneous coronary intervention. Seventeen had a scar area > 75% in at least one anteroseptal segment (scar) and thirteen had scar area < 1% (non-scar). Velocity, displacement and strain were calculated in the longitudinal direction, tangential to the endocardial outline, and in the radial direction, perpendicular to the tangent. Results: In the scar patients, segments with scar showed lower functional measurements than remote segments. Radial measurements of velocity, displacement and strain performed better in terms of receiver-operator-characteristic curves (ROC) than the corresponding longitudinal measurements. The best area-under-curve was for radial strain, 0.89, where a cut-off value of 38.8% had 80% sensitivity and 86% specificity for the detection of a segment with scar area > 50%. As a percentage of the mean, intraobserver variability was 16-14-26% for radial measurements of displacement-velocity-strain and corresponding interobserver variability was 13-12-18%. Conclusion: Feature tracking analysis of cine-MR displays velocity, displacement and strain in the radial and longitudinal direction and may be used for the detection of transmural scar. The accuracy and repeatability of the radial functional measurements is satisfactory and global measures agree.
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页数:14
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