Intra-observer and interobserver variability of biventricular function, volumes and mass in patients with congenital heart disease measured by CMR imaging

Luijnenburg, Saskia E.; Robbers‐Visser, Daniëlle; Moelker, Adriaan; Vliegen, Hubert W.; Mulder, Barbara J.M.; Helbing, Willem A.

doi:10.1007/s10554-009-9501-y

Cited by 104 publications

(38 citation statements)

References 26 publications

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“…Similar to prior studies using cine SSFP, we confirmed that for all measurements, the limits of agreement are wider for the RV compared to the LV (18, 42–44). Because of its complex geometry, accurate and reliable quantification of RV volume can be challenging, particularly in the setting of abnormal RV anatomy in patients with CHD (45). Values for inter-observer agreement of LV volumes and mass in our study (ICC 0.957–0.993) are similar to previously reported values (ICC 0.94–0.99) (18).…”

Section: Discussionsupporting

confidence: 89%

Assessment of the precision and reproducibility of ventricular volume, function, and mass measurements with ferumoxytol‐enhanced 4D flow MRI

Hanneman

Kino

Cheng

et al. 2016

Magnetic Resonance Imaging

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Purpose To compare the precision and inter-observer agreement of ventricular volume, function and mass quantification by three-dimensional time-resolved (4D) flow MRI relative to cine steady state free precession (SSFP). Materials and Methods With research board approval, informed consent, and HIPAA compliance, 22 consecutive patients with congenital heart disease (CHD) (10 males, 6.4±4.8 years) referred for 3T ferumoxytol-enhanced cardiac MRI were prospectively recruited. Complete ventricular coverage with standard 2D short-axis cine SSFP and whole chest coverage with axial 4D flow were obtained. Two blinded radiologists independently segmented images for left ventricular (LV) and right ventricular (RV) myocardium at end systole (ES) and end diastole (ED). Statistical analysis included linear regression, ANOVA, Bland-Altman (BA) analysis, and intra-class correlation (ICC). Results Significant positive correlations were found between 4D flow and SSFP for ventricular volumes (r = 0.808–0.972, p<0.001), ejection fraction (EF) (r = 0.900–928, p<0.001), and mass (r = 0.884–0.934, p<0.001). BA relative limits of agreement for both ventricles were between −52% to 34% for volumes, −29% to 27% for EF, and −41% to 48% for mass, with wider limits of agreement for the RV compared to the LV. There was no significant difference between techniques with respect to mean square difference of ED-ES mass for either LV (F=2.05, p=0.159) or RV (F=0.625, p=0.434). Inter-observer agreement was moderate to good with both 4D flow (ICC 0.523–0.993) and SSFP (ICC 0.619–0.982), with overlapping confidence intervals. Conclusion Quantification of ventricular volume, function and mass can be accomplished with 4D flow MRI with precision and inter-observer agreement comparable to that of cine SSFP.

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Section: Discussionsupporting

confidence: 89%

Assessment of the precision and reproducibility of ventricular volume, function, and mass measurements with ferumoxytol‐enhanced 4D flow MRI

Hanneman

Kino

Cheng

et al. 2016

Magnetic Resonance Imaging

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“…However, for frequent, serial assessments, echocardiography is preferred. [122][123][124][125][126] The most common use for MRI in pediatric PH patients is to assess RV size, mass, and function in the initial evaluation and during follow-up. Cardiac MRI is also used to quantify biventricular volumes and pulmonary blood flow, to assess cardiopulmonary anatomy, and to determine pulmonary artery mechanical properties.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Pediatric Pulmonary Hypertension

Abman¹,

Hansmann²,

Archer³

et al. 2015

Circulation

927

405

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Abstract-Pulmonary hypertension is associated with diverse cardiac, pulmonary, and systemic diseases in neonates, infants, and older children and contributes to significant morbidity and mortality. However, current approaches to caring for pediatric patients with pulmonary hypertension have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic Society, a panel of experienced clinicians and clinician-scientists was assembled to review the current literature and to make recommendations on the diagnosis, evaluation, and treatment of pediatric pulmonary hypertension. This publication presents the results of extensive literature reviews, discussions, and formal scoring of recommendations for the care of children with pulmonary hypertension. Key Words: AHA Scientific Statements ◼ bronchopulmonary dysplasia ◼ congenital diaphragmatic hernia ◼ congenital heart disease ◼ genetics ◼ persistent pulmonary hypertension of the newborn ◼ sickle cell disease © 2015 by the American Heart Association, Inc., and the American Thoracic Society.Circulation is available at http://circ.ahajournals.org DOI: 10.1161/CIR.0000000000000329 †Deceased. The American Heart Association and the American Thoracic Society make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This document was approved by the American Heart Association Science Advisory and Coordinating Committee on May 12, 2015, the American Heart Association Executive Committee on July 22, 2015, and the American Thoracic Society on July 24, 2015.The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl/doi:10.1161/CIR.0000000000000329/-/DC1. The American Heart Association requests that this document be cited as follows: Abman SH, Hansmann G, Archer SL, Ivy DD, Adatia I, Chung WK, Hanna BD, Rosenzweig EB, Raj JU, Cornfield D, Stenmark KR, Steinhorn R, Thébaud B, Fineman JR, Kuehne T, Feinstein JA, Friedberg MK, Earing M, Barst RJ, Keller RL, Kinsella JP, Mullen M, Deterding R, Kulik T, Mallory G, Humpl T, Wessel DL; on behalf of the American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Clinical Cardiology, Council on Cardiovascular Disease in the Young, Council on Cardiovascular Radiology and Intervention, Council on Cardiovascular Surgery and Anesthesia, and the American Thoracic Society. Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society. Circulation. 2015;132:2037-2099 Copies: This document is available on the World Wide Web site of the American Heart Associat...

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“…Cardiac MR imaging is increasingly essential for many of these patients, particularly because of (a) its proven quantitative accuracy and reproducibility in the evaluation of ventricular size and blood flow (1)(2)(3)(4)(5) and (b) its ability to delineate extracardiac structures without ionizing radiation. At present, this is usually accomplished by using a series of predominantly planar pulse sequences, including two-dimensional (2D) cine phase-contrast and 2D cine balanced steady-state free precession sequences.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Valvular Insufficiency and Shunts with Parallel-imaging Compressed-sensing 4D Phase-contrast MR Imaging with Stereoscopic 3D Velocity-fusion Volume-rendered Visualization

Hsiao¹,

Lustig²,

Alley³

et al. 2012

Radiology

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Purpose:To assess the potential of compressed-sensing parallel-imaging four-dimensional (4D) phase-contrast magnetic resonance (MR) imaging and specialized imaging software in the evaluation of valvular insufficiency and intracardiac shunts in patients with congenital heart disease. Materials andMethods:Institutional review board approval was obtained for this HIPAAcompliant study. Thirty-four consecutive retrospectively identified patients in whom a compressed-sensing parallel-imaging 4D phase-contrast sequence was performed as part of routine clinical cardiac MR imaging between March 2010 and August 2011 and who had undergone echocardiography were included. Multiplanar, volume-rendered, and stereoscopic three-dimensional velocityfusion visualization algorithms were developed and implemented in Java and OpenGL. Two radiologists independently reviewed 4D phase-contrast studies for each of 34 patients (mean age, 6 years; age range, 10 months to 21 years) and tabulated visible shunts and valvular regurgitation. These results were compared with color Doppler echocardiographic and cardiac MR imaging reports, which were generated without 4D phase-contrast visualization. Cohen k statistics were computed to assess interobserver agreement and agreement with echocardiographic results. Results:The 4D phase-contrast acquisitions were performed, on average, in less than 10 minutes. Among 123 valves seen in 34 4D phasecontrast studies, 29 regurgitant valves were identified, with good agreement between observers (k = 0.85). There was also good agreement with the presence of at least mild regurgitation at echocardiography (observer 1, k = 0.76; observer 2, k = 0.77) with high sensitivity (observer 1, 75%; observer 2, 82%) and specificity (observer 1, 97%; observer 2, 95%) relative to the reference standard. Eight intracardiac shunts were identified, four of which were not visible with conventional cardiac MR imaging but were detected with echocardiography. No intracardiac shunts were found with echocardiography alone. Conclusion:With velocity-fusion visualization, the compressed-sensing parallel-imaging 4D phase-contrast sequence can augment conventional cardiac MR imaging by improving sensitivity for and depiction of hemodynamically significant shunts and valvular regurgitation.q RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup /suppl

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Intra-observer and interobserver variability of biventricular function, volumes and mass in patients with congenital heart disease measured by CMR imaging

Cited by 104 publications

References 26 publications

Assessment of the precision and reproducibility of ventricular volume, function, and mass measurements with ferumoxytol‐enhanced 4D flow MRI

Assessment of the precision and reproducibility of ventricular volume, function, and mass measurements with ferumoxytol‐enhanced 4D flow MRI

Pediatric Pulmonary Hypertension

Evaluation of Valvular Insufficiency and Shunts with Parallel-imaging Compressed-sensing 4D Phase-contrast MR Imaging with Stereoscopic 3D Velocity-fusion Volume-rendered Visualization

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