Quantitative assessment of myocardial strain with displacement encoding with stimulated echoes MRI in patients with coro
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ORIGINAL PAPER
Quantitative assessment of myocardial strain with displacement encoding with stimulated echoes MRI in patients with coronary artery disease Hideki Miyagi • Motonori Nagata • Kakuya Kitagawa • Shingo Kato Shinichi Takase • Andreas Sigfridsson • Masaki Ishida • Kaoru Dohi Masaaki Ito • Hajime Sakuma
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Received: 23 May 2013 / Accepted: 3 August 2013 Ó Springer Science+Business Media Dordrecht 2013
Abstract To determine the diagnostic performance and reproducibility of strain assessment with displacement encoding with stimulated echoes (DENSE) cardiovascular magnetic resonance (CMR) in identifying contractile abnormalities in myocardial segments with late gadolinium enhancement (LGE). DENSE CMR was obtained on shortaxis planes of the left ventricle (LV) in 24 patients with suspected coronary artery disease. e1 and e2 strains of LV wall were quantified. Cine MRI was acquired to determine percent systolic wall thickening (%SWT), followed by (LGE) CMR. The diagnostic performance of e1, e2 and %SWT for predicting the presence of LGE was evaluated by receiver operating characteristics (ROC) analysis. Myocardial scar on LGE CMR was observed in 91 (24 %) of 384 segments. The area under ROC curve for predicting the segments with LGE was 0.874 by e1, 0.916 by e2 and 0.828 by %SWT (p = 0.001 between e2 and %SWT). Excellent inter-observer reproducibility was found for strain [Intraclass correlation coefficient (ICC) = 0.962 for e1, 0.955 for e2] as compared with %SWT (ICC = 0.790). DENSE CMR can be performed as a part of routine CMR study and allows for quantification of myocardial strain with high inter-observer reproducibility. Myocardial strain, H. Miyagi M. Nagata K. Kitagawa S. Kato S. Takase M. Ishida H. Sakuma (&) Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan e-mail: [email protected] A. Sigfridsson Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden K. Dohi M. Ito Department of Cardiology, Mie University Hospital, Tsu, Mie, Japan
especially e2 is useful in detecting altered abnormal systolic contraction in the segments with myocardial scar. Keywords Magnetic resonance imaging Myocardial strain Myocardial infarction Displacement encoding with stimulated echoes Cine magnetic resonance imaging
Introduction Accurate and reproducible assessment of the extent and degree of contractile dysfunction after myocardial infarction (MI) is important for making adequate therapeutic decisions [1, 2] evaluating the effectiveness of therapy [3, 4], and predicting the prognosis [3, 5, 6]. Cine cardiovascular magnetic resonance (CMR) permits precise measurements of regional and global left ventricular (LV) function and mass owing to excellent delineation of both endocardial and epicardial borders of the LV wall as well as its independency on geometric assumptions in calculating volume [1, 7]. Regional contractile function has been assessed by measuring wall thickening and percent sys
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