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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 expressed as differential strain versus the detection of >50 % transmurality of scar. Diff circ endo = subendocardial circumferential differential strain, Diff circ epi = epicardial circumferential differential strain, Diff circ = transmural circumferential differential strain, Diff long = longitudinal differential strain
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Fig4: ROC curves for layer strain expressed as differential strain versus the detection of >50 % transmurality of scar. Diff circ endo = subendocardial circumferential differential strain, Diff circ epi = epicardial circumferential differential strain, Diff circ = transmural circumferential differential strain, Diff long = longitudinal differential strain

Mentions: AUC for various strain components is shown in Table 4, which also depicts sensitivity and specificity for different cut-off levels. Best AUC was for subendocardial circumferential strain, which detected segments with scar area >50 % with 94 % sensitivity at 80 % specificity. Analysis of differential strain (Fig. 4, Table 5) did not significantly improve the detection rate for scar.Table 4


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 expressed as differential strain versus the detection of >50 % transmurality of scar. Diff circ endo = subendocardial circumferential differential strain, Diff circ epi = epicardial circumferential differential strain, Diff circ = transmural circumferential differential strain, Diff long = longitudinal differential strain
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig4: ROC curves for layer strain expressed as differential strain versus the detection of >50 % transmurality of scar. Diff circ endo = subendocardial circumferential differential strain, Diff circ epi = epicardial circumferential differential strain, Diff circ = transmural circumferential differential strain, Diff long = longitudinal differential strain
Mentions: AUC for various strain components is shown in Table 4, which also depicts sensitivity and specificity for different cut-off levels. Best AUC was for subendocardial circumferential strain, which detected segments with scar area >50 % with 94 % sensitivity at 80 % specificity. Analysis of differential strain (Fig. 4, Table 5) did not significantly improve the detection rate for scar.Table 4

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