Reproducibility of cine displacement encoding with stimulated echoes (DENSE) in human subjects

Abstract

Objectives To test the hypothesis that two-dimensional (2D) displacement encoding via stimulated echoes (DENSE) is a reproducible technique for the depiction of segmental myocardial motion in human subjects. Materials and methods Following the approval of the institutional review board (IRB), 17 healthy volunteers without documented history of cardiovascular disease were recruited. For each participant, 2D DENSE were performed twice (at different days) and the images were obtained at basal, midventricular and apical levels of the left ventricle (LV) with a short-axis view. The radial thickening strain (Err), circumferential strain (Ecc), twist and torsion were calculated. The intra-, inter-observer and inter-study variations of DENSE-derived myocardial motion indices were evaluated using coefficient of variation (CoV) and intra-class correlation coefficient (ICC). Results In total, there are 272 pairs of myocardial segments (data points) for comparison. There is good intra- and inter-observer reproducibility for all DENSE-derived measures in 17 participants. There is good inter-study reproducibility for peak Ecc (CoV = 19.64%, ICC = 0.8896, p < 0.001), twist (CoV= 33.11%, ICC = 0.9135, p < 0.001) and torsion (CoV = 13.96%, ICC = 0.8684, p < 0.001). There is moderate inter-study reproducibility for Err (CoV = 38.89%, ICC = 0.7022, p < 0.001). Conclusion DENSE is a reproducible technique for characterizing LV regional systolic myocardial motion on a per-segment basis in healthy volunteers.

Imaging left‐ventricular mechanical activation in heart failure patients using cine DENSE MRI: Validation and implications for cardiac resynchronization therapy

“…Regarding the choice to use circumferential rather than radial strain in this study, we have previously shown the superiority of DENSE circumferential strain over radial strain for the quantification of dyssynchrony, a parameter closely related to mechanical activation time. Also, it has been shown that cine DENSE assessment of circumferential strain is more reproducible than radial strain . Furthermore, the finding that circumferential strain performs well for this application makes physiologic sense based on the circumferential orientation of midwall myocardial fibers, as shown by diffusion tensor imaging in a canine model of dyssynchrony .…”

“…Also, it has been shown that cine DENSE assessment of circumferential strain is more reproducible than radial strain. 19,32 Furthermore, the finding that circumferential strain performs well for this application makes physiologic sense based on the circumferential orientation of midwall myocardial fibers, as shown by diffusion tensor imaging in a canine model of dyssynchrony. 33 Lastly, radial strain is particularly poorly suited for this application because HF-CRT patients often have dilated ventricles with decreased wall thickness.…”

“…Semiautomatic strain analysis methods for cine DENSE have been described previously 18,23,24 and were used to compute regional circumferential strain (E cc ) for the cine DENSE images. For each slice, midwall E cc was computed for 18 circumferential segments and for all (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) cardiac phases. To facilitate the automatic computation of TOS, the spatiotemporal midwall E cc data were arranged into a 2D matrix consisting of N rows and M columns, where N represents the number of spatial segments and M represents the number of cardiac phases.…”

Organ‐level validation of a cross‐bridge cycling descriptor in a left ventricular finite element model: effects of ventricular loading on myocardial strains

“…; Lin et al. ), echo‐based studies are less clear concerning the type of metric used in computing myocardial strains. A number of echo‐based studies have described Lagrangian and Eulerian strain (Dandel et al.…”

Illuminating the Path Forward in Cardiac Regeneration Using Strain Magnetic Resonance Imaging

“…Thus, accurate and reproducible high-resolution MRI strain imaging with rapid analysis has been demonstrated for both preclinical and clinical applications (12, 13). …”