Reproducibility of in-vivo diffusion tensor cardiovascular magnetic resonance in hypertrophic cardiomyopathy

Journal of Cardiovascular Magnetic Resonance

Research

Tevfik F Ismail¹  Michael Roughton¹  Peter D Gatehouse¹  Laura-Ann McGill²  Andrew D Scott²  S Yen Ho²  Pedro Ferreira²  Philip J Kilner²  Ranil de Silva²  Sanjay K Prasad²  Dudley J Pennell²  Karen P McCarthy²  David N Firmin²  Sonia Nielles-Vallespin³  Peter Speier⁴  Thorsten Feiweier⁴  Choukkri Mekkaoui⁵  David E Sosnovik⁵ 

[1] Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, SW3 6NP, London, United Kingdom;Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, SW3 6NP, London, United Kingdom;National Heart and Lung Institute, Imperial College, London, UK;Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, SW3 6NP, London, United Kingdom;National Heart and Lung Institute, Imperial College, London, UK;National Heart Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), DHHS, Bethesda, MD, USA;MR R&D, Siemens AG Medical Solutions, Erlangen, Germany;Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA;

关键词: Hypertrophic cardiomyopathy;    Diffusion tensor imaging;    Diffusion weighted imaging;    Cardiovascular magnetic resonance;    Disarray;   

DOI  :  10.1186/1532-429X-14-86

 received in 2012-12-18, accepted in 2012-12-19,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundMyocardial disarray is an important histological feature of hypertrophic cardiomyopathy (HCM) which has been studied post-mortem, but its in-vivo prevalence and extent is unknown. Cardiac Diffusion Tensor Imaging (cDTI) provides information on mean intravoxel myocyte orientation and potentially myocardial disarray. Recent technical advances have improved in-vivo cDTI, and the aim of this study was to assess the interstudy reproducibility of quantitative in-vivo cDTI in patients with HCM.Methods and resultsA stimulated-echo single-shot-EPI sequence with zonal excitation and parallel imaging was implemented. Ten patients with HCM were each scanned on 2 different days. For each scan 3 short axis mid-ventricular slices were acquired with cDTI at end systole. Fractional anisotropy (FA), mean diffusivity (MD), and helix angle (HA) maps were created using a cDTI post-processing platform developed in-house. The mean ± SD global FA was 0.613 ± 0.044, MD was 0.750 ± 0.154 × 10-3 mm2/s and HA was epicardium −34.3 ± 7.6°, mesocardium 3.5 ± 6.9° and endocardium 38.9 ± 8.1°. Comparison of initial and repeat studies showed global interstudy reproducibility for FA (SD = ± 0.045, Coefficient of Variation (CoV) = 7.2%), MD (SD = ± 0.135 × 10-3 mm2/s, CoV = 18.6%) and HA (epicardium SD = ± 4.8°; mesocardium SD = ± 3.4°; endocardium SD = ± 2.9°). Reproducibility of FA was superior to MD (p = 0.003). Global MD was significantly higher in the septum than the reference lateral wall (0.784 ± 0.188 vs 0.750 ± 0.154 x10-3 mm2/s, p < 0.001). Septal HA was significantly lower than the reference lateral wall in all 3 transmural layers (from −8.3° to −10.4°, all p < 0.001).ConclusionsTo the best of our knowledge, this is the first study to assess the interstudy reproducibility of DTI in the human HCM heart in-vivo and the largest cDTI study in HCM to date. Our results show good reproducibility of FA, MD and HA which indicates that current technology yields robust in-vivo measurements that have potential clinical value. The interpretation of regional differences in the septum requires further investigation.

【 授权许可】

Unknown   
© McGill et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.