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Clinical experience of strain imaging using DENSE for detecting infarcted cardiac segments.

Kihlberg J, Haraldsson H, Sigfridsson A, Ebbers T, Engvall JE - J Cardiovasc Magn Reson (2015)

Bottom Line: We hypothesised that myocardial deformation determined with magnetic resonance imaging (MRI) will detect myocardial scar.Using a cut-off value of -17%, sensitivity was 95% at a specificity of 80%.Interobserver and scan-rescan reproducibility was high with an intraclass correlation coefficient (ICC) >0.93.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. johan.kihlberg@cmiv.liu.se.

ABSTRACT

Background: We hypothesised that myocardial deformation determined with magnetic resonance imaging (MRI) will detect myocardial scar.

Methods: Displacement Encoding with Stimulated Echoes (DENSE) was used to calculate left ventricular strain in 125 patients (29 women and 96 men) with suspected coronary artery disease. The patients also underwent cine imaging and late gadolinium enhancement. 57 patients had a scar area >1% in at least one segment, 23 were considered free from coronary artery disease (control group) and 45 had pathological findings but no scar (mixed group). Peak strain was calculated in eight combinations: radial and circumferential strain in transmural, subendocardial and epicardial layers derived from short axis acquisition, and transmural longitudinal and radial strain derived from long axis acquisitions. In addition, the difference between strain in affected segments and reference segments, "differential strain", from the control group was analysed.

Results: In receiver-operator-characteristic analysis for the detection of 50% transmurality, circumferential strain performed best with area-under-curve (AUC) of 0.94. Using a cut-off value of -17%, sensitivity was 95% at a specificity of 80%. AUC did not further improve with differential strain. There were significant differences between the control group and global strain circumferential direction (-17% versus -12%) and in the longitudinal direction (-13% versus -10%). Interobserver and scan-rescan reproducibility was high with an intraclass correlation coefficient (ICC) >0.93.

Conclusions: DENSE-derived circumferential strain may be used for the detection of myocardial segments with >50 % scar area. The repeatability of strain is satisfactory. DENSE-derived global strain agrees with other global measures of left ventricular ejection fraction.

No MeSH data available.


Related in: MedlinePlus

ROC curves for layer strain and the detection of >50 % transmurality of scar. Circ trans = transmural circumferential strain, Circ endo = subendocardial circumferential strain, Circ epi = epicardial circumferential strain and Long = Longitudinal strain
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Fig3: ROC curves for layer strain and the detection of >50 % transmurality of scar. Circ trans = transmural circumferential strain, Circ endo = subendocardial circumferential strain, Circ epi = epicardial circumferential strain and Long = Longitudinal strain

Mentions: Receiver-operator curves were constructed for different combinations of strain directions and layers to assess their ability to identify segments with transmurality >50 %. Fig. 3 shows Area-under-curve (AUC) in excess of 0.80 for the eight combinations of strain layers and directions, which are four combinations; circumferential subendocardial, circumferential epicardial, circumferential transmural and longitudinal transmural strain.Fig. 3


Clinical experience of strain imaging using DENSE for detecting infarcted cardiac segments.

Kihlberg J, Haraldsson H, Sigfridsson A, Ebbers T, Engvall JE - J Cardiovasc Magn Reson (2015)

ROC curves for layer strain and the detection of >50 % transmurality of scar. Circ trans = transmural circumferential strain, Circ endo = subendocardial circumferential strain, Circ epi = epicardial circumferential strain and Long = Longitudinal strain
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4478716&req=5

Fig3: ROC curves for layer strain and the detection of >50 % transmurality of scar. Circ trans = transmural circumferential strain, Circ endo = subendocardial circumferential strain, Circ epi = epicardial circumferential strain and Long = Longitudinal strain
Mentions: Receiver-operator curves were constructed for different combinations of strain directions and layers to assess their ability to identify segments with transmurality >50 %. Fig. 3 shows Area-under-curve (AUC) in excess of 0.80 for the eight combinations of strain layers and directions, which are four combinations; circumferential subendocardial, circumferential epicardial, circumferential transmural and longitudinal transmural strain.Fig. 3

Bottom Line: We hypothesised that myocardial deformation determined with magnetic resonance imaging (MRI) will detect myocardial scar.Using a cut-off value of -17%, sensitivity was 95% at a specificity of 80%.Interobserver and scan-rescan reproducibility was high with an intraclass correlation coefficient (ICC) >0.93.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. johan.kihlberg@cmiv.liu.se.

ABSTRACT

Background: We hypothesised that myocardial deformation determined with magnetic resonance imaging (MRI) will detect myocardial scar.

Methods: Displacement Encoding with Stimulated Echoes (DENSE) was used to calculate left ventricular strain in 125 patients (29 women and 96 men) with suspected coronary artery disease. The patients also underwent cine imaging and late gadolinium enhancement. 57 patients had a scar area >1% in at least one segment, 23 were considered free from coronary artery disease (control group) and 45 had pathological findings but no scar (mixed group). Peak strain was calculated in eight combinations: radial and circumferential strain in transmural, subendocardial and epicardial layers derived from short axis acquisition, and transmural longitudinal and radial strain derived from long axis acquisitions. In addition, the difference between strain in affected segments and reference segments, "differential strain", from the control group was analysed.

Results: In receiver-operator-characteristic analysis for the detection of 50% transmurality, circumferential strain performed best with area-under-curve (AUC) of 0.94. Using a cut-off value of -17%, sensitivity was 95% at a specificity of 80%. AUC did not further improve with differential strain. There were significant differences between the control group and global strain circumferential direction (-17% versus -12%) and in the longitudinal direction (-13% versus -10%). Interobserver and scan-rescan reproducibility was high with an intraclass correlation coefficient (ICC) >0.93.

Conclusions: DENSE-derived circumferential strain may be used for the detection of myocardial segments with >50 % scar area. The repeatability of strain is satisfactory. DENSE-derived global strain agrees with other global measures of left ventricular ejection fraction.

No MeSH data available.


Related in: MedlinePlus