Quality assessment of cardiovascular magnetic resonance in the setting of the European CMR registry: description and validation of standardized criteria

Journal of Cardiovascular Magnetic Resonance

Juerg Schwitter⁶  Heiko Mahrholdt⁹  Oliver Bruder⁴  Anja Wagner⁵  Albert C van Rossum²  Massimo Lombardi⁷  Guenter Pilz¹  Detlev Nothnagel³  Christian Lu⁸  Pierre Monney⁶  Gabriella Vincenti⁶  Didier Locca⁶  Nathalie Lauriers⁶  Stefano Muzzarelli^1,10  Vincenzo Klinke⁶ 

[1] Department of Cardiology, Clinic Agatharied, Academic Teaching Hospital, University of Munich, Munich, Germany;Department of Cardiology, VU Medical Centre, Amsterdam, The Netherlands;Department of Cardiology, Klinikum Ludwigsburg, Ludwigsburg, Germany;Department of Cardiology, Elisabeth Hospital Essen, Essen, Germany;Department of Cardiology, Hahnemann University Hospital, Drexel University, College of Medicine, Philadelphia, USA;Department of Cardiology, Center of Cardiac Magnetic Resonance (CRMC), University Hospital Lausanne, Lausanne, Switzerland;Clinical Physiology Institute / G. Monasterio Foundation, Pisa, Italy;Department of Radiology, University Hospital Lausanne, Lausanne, Switzerland;Department of Cardiology, Robert Bosch Hospital Stuttgart, Stuttgart, Germany;Department of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland

关键词: Stress First Pass Myocardial Perfusion;    Cine Images;    Late Gadolinium Enhancement Images;    Quality Score;    Image Quality;    Cardiac Magnetic Resonance;   

Others  :  828885
DOI  :  10.1186/1532-429X-15-55

 received in 2013-01-28, accepted in 2013-05-16,  发布年份 2013

【 摘 要 】

Background

Cardiovascular magnetic resonance (CMR) has become an important diagnostic imaging modality in cardiovascular medicine. However, insufficient image quality may compromise its diagnostic accuracy. We aimed to describe and validate standardized criteria to evaluate a) cine steady-state free precession (SSFP), b) late gadolinium enhancement (LGE), and c) stress first-pass perfusion images. These criteria will serve for quality assessment in the setting of the Euro-CMR registry.

Methods

Thirty-five qualitative criteria were defined (scores 0–3) with lower scores indicating better image quality. In addition, quantitative parameters were measured yielding 2 additional quality criteria, i.e. signal-to-noise ratio (SNR) of non-infarcted myocardium (as a measure of correct signal nulling of healthy myocardium) for LGE and % signal increase during contrast medium first-pass for perfusion images. These qualitative and quantitative criteria were assessed in a total of 90 patients (60 patients scanned at our own institution at 1.5T (n=30) and 3T (n=30) and in 30 patients randomly chosen from the Euro-CMR registry examined at 1.5T). Analyses were performed by 2 SCMR level-3 experts, 1 trained study nurse, and 1 trained medical student.

Results

The global quality score was 6.7±4.6 (n=90, mean of 4 observers, maximum possible score 64), range 6.4-6.9 (p=0.76 between observers). It ranged from 4.0-4.3 for 1.5T (p=0.96 between observers), from 5.9-6.9 for 3T (p=0.33 between observers), and from 8.6-10.3 for the Euro-CMR cases (p=0.40 between observers). The inter- (n=4) and intra-observer (n=2) agreement for the global quality score, i.e. the percentage of assignments to the same quality tertile ranged from 80% to 88% and from 90% to 98%, respectively. The agreement for the quantitative assessment for LGE images (scores 0–2 for SNR <2, 2–5, >5, respectively) ranged from 78-84% for the entire population, and 70-93% at 1.5T, 64-88% at 3T, and 72-90% for the Euro-CMR cases. The agreement for perfusion images (scores 0–2 for %SI increase >200%, 100%-200%,<100%, respectively) ranged from 81-91% for the entire population, and 76-100% at 1.5T, 67-96% at 3T, and 62-90% for the Euro-CMR registry cases. The intra-class correlation coefficient for the global quality score was 0.83.

Conclusions

The described criteria for the assessment of CMR image quality are robust with a good inter- and intra-observer agreement. Further research is needed to define the impact of image quality on the diagnostic and prognostic yield of CMR studies.

【 授权许可】

   
2013 Klinke et al.; licensee BioMed Central Ltd.

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