Abstract
Introduction: Assessment of myocardial regional wall motion plays a key role in many diagnostic and therapeutic decisions in current clinical practice. Semi-quantitative grading or regional wall motion is the most frequently applied technique, but is highly subjective with limited reproducibility. Despite dramatic improvements in echocardiography and cardiovascular magnetic resonance technology, permitting quantitative and objective regional wall motion analysis, none has yet been widely applied in clinical practice.
Purpose: We aimed to establish prospectively a database of normal, three-dimensional, systolic and diastolic, endo- and epicardial velocities of all myocardial segments in healthy volunteers using cine phase contrast velocity magnetic resonance imaging (‘tissue phase mapping’ or TPM).
Methods: 96 healthy volunteers (mean ± SD age = 38 ± 12 years, 57 [59%] men) underwent cardiac phase contrast imaging using a black blood k-space segmented gradient echo sequence for the analysis of three-dimensional myocardial velocities with high spatial resolution at 1.5 Tesla in basal, mid-ventricular and apical short axis views. Eighteen consecutive volunteers were scanned twice for inter-study reproducibility and were analysed for intra- and inter-observer variability. Systolic and diastolic velocity curves were analyzed for peak velocities and time to peak velocities in the radial, circumferential and longitudinal direction as well as torsion-rate and longitudinal strain-rate. Mixed effects models with a random intercept for volunteer were used to test for differences between the three ventricular slices and transmural endo- and epicardial parameters.
Results: TPM enabled a reproducible assessment of myocardial velocities with small intra- and inter-observer variability (Fig. 1). Systolic peak radial velocity was lowest at apical level (p < 0.001), diastolic peak radial velocity was similar at all three myocardial levels (p = 0.73, Table 1). As viewed from the apex, a relative counter-clockwise rotation during systole was followed by a relative clockwise rotation of the apex against the base. Diastolic and systolic peak longitudinal velocities decreased from base to apex (p < 0.001). A gradient between endo- and epicardium could be observed for radial velocities with greater endocardial velocities (p < 0.001).
Conclusions: Tissue phase mapping is a reproducible, comprehensive modality to assess regional wall motion, and intra- and inter-observer and inter-study variabilities are low.
Purpose: We aimed to establish prospectively a database of normal, three-dimensional, systolic and diastolic, endo- and epicardial velocities of all myocardial segments in healthy volunteers using cine phase contrast velocity magnetic resonance imaging (‘tissue phase mapping’ or TPM).
Methods: 96 healthy volunteers (mean ± SD age = 38 ± 12 years, 57 [59%] men) underwent cardiac phase contrast imaging using a black blood k-space segmented gradient echo sequence for the analysis of three-dimensional myocardial velocities with high spatial resolution at 1.5 Tesla in basal, mid-ventricular and apical short axis views. Eighteen consecutive volunteers were scanned twice for inter-study reproducibility and were analysed for intra- and inter-observer variability. Systolic and diastolic velocity curves were analyzed for peak velocities and time to peak velocities in the radial, circumferential and longitudinal direction as well as torsion-rate and longitudinal strain-rate. Mixed effects models with a random intercept for volunteer were used to test for differences between the three ventricular slices and transmural endo- and epicardial parameters.
Results: TPM enabled a reproducible assessment of myocardial velocities with small intra- and inter-observer variability (Fig. 1). Systolic peak radial velocity was lowest at apical level (p < 0.001), diastolic peak radial velocity was similar at all three myocardial levels (p = 0.73, Table 1). As viewed from the apex, a relative counter-clockwise rotation during systole was followed by a relative clockwise rotation of the apex against the base. Diastolic and systolic peak longitudinal velocities decreased from base to apex (p < 0.001). A gradient between endo- and epicardium could be observed for radial velocities with greater endocardial velocities (p < 0.001).
Conclusions: Tissue phase mapping is a reproducible, comprehensive modality to assess regional wall motion, and intra- and inter-observer and inter-study variabilities are low.
Original language | English |
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Article number | Poster 490. |
Number of pages | 1 |
Journal | Journal of Cardiovascular Magnetic Resonance |
Volume | 8 |
Issue number | 1 |
DOIs | |
Publication status | Published - 2006 |
Externally published | Yes |