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

Research

Massimo Lombardi¹  Nathalie Lauriers²  Didier Locca²  Juerg Schwitter²  Pierre Monney²  Gabriella Vincenti²  Vincenzo Klinke²  Stefano Muzzarelli³  Guenter Pilz⁴  Oliver Bruder⁵  Anja Wagner⁶  Detlev Nothnagel⁷  Heiko Mahrholdt⁸  Albert C van Rossum⁹  Christian Lu^1,10 

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

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

DOI  :  10.1186/1532-429X-15-55

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

来源: Springer

【 摘 要 】

BackgroundCardiovascular 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.MethodsThirty-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.ResultsThe 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.ConclusionsThe 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】

Unknown   
© Klinke et al.; licensee BioMed Central Ltd. 2013. 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.