心脏MR压缩感知超快速电影序列评价左右心室收缩功能的应用价值

Evaluation of left and right ventricular systolic function by cardiac MR compressed sensing ultrafast cine sequence

目的对比传统分段采集电影序列(Seg), 探讨心脏MR(CMR)压缩感知(CS)超快速电影序列评价左右心室收缩功能的临床应用价值。方法前瞻性纳入2021年12月至2022年1月在阜外医院进行CMR检查的心脏疾病患者27例。随机顺序进行Seg、屏气下CS(bhCS)和自由呼吸下CS(fbCS)覆盖左右心室的多层短轴电影扫描。采用Friedman检验评价3种方法的总体图像质量、血池心肌信号比(BMC)和边缘锐度。分别测量3种方法的左心室舒张末期容积(EDV)、收缩末期容积(ESV)、每博输出量(SV)、射血分数(EF)、心肌质量(mass)及右心室EDV、ESV、SV、EF, 并用Bland-Altman分析bhCS与Seg、fbCS与Seg间测量结果的一致性, 并做相关性检验。结果 24例患者3种方法所有总体图像质量≥2分, 有诊断意义, 纳入后续分析。Seg、bhCS和fbCS的成像时间不同且依次降低, 分别为375.0(332.0, 405.6)、50.0(47.8, 53.7)和20.0(17.8, 23.7)s, 差异有统计学意义(χ^(2)=48.00, P<0.001)。总体图像质量fbCS略低于Seg(Z=-2.67, P=0.023), Seg和bhCS(Z=-1.44, P=0.447)、bhCS和fbCS(Z=1.23, P=0.660)之间差异无统计学意义。Seg、bhCS和fbCS的边缘锐度(χ^(2)=0.58, P=0.747)和BMC(χ^(2)=1.08, P=0.582)差异无统计学意义。Bland-Altman分析表明bhCS和Seg、fbCS和Seg之间左右心室各参数均具有良好的一致性。相关性分析结果显示bhCS和Seg、fbCS和Seg的各心功能参数均呈高度相关(r>0.96, P<0.001)。结论 CS超快速电影序列比传统序列节省了扫描时间且提供了相似的图像质量, 且无论是否屏气, CS序列心功能结果与传统电影序列具有良好的一致性和高度的相关性。

Objective To explore the clinical value of cardiac MR(CMR)compression sensing(CS)ultrafast cine sequence in evaluating left and right ventricular systolic function by comparing with traditional segmented acquisition cine sequence(Seg).Methods Twenty-seven patients with various heart disease were prospectively included.Seg,breath holding CS(bhCS)and free breathing CS(fbCS)covering the left and right ventricles using multi slices in short axis were performed in random order.Friedman test was used to evaluate the overall image quality(grade 1-5 score),blood pool myocardial signal ratio(BMC)and edge sharpness under different methods.Biventricular end diastolic volume(EDV),end systolic volume(ESV),stroke volume(SV),ejection fraction(EF)and left ventricular myocardial mass(Mass)were measured for all three methods.The agreements of the functional measurements between bhCS and Seg(gold standard),and between fbCS and Seg were analyzed by Bland-Altman,and the correlation test was performed.Results Twenty-four patients with diagnostic images(overall image quality score≥2)for all three methods were included in further analysis.The total imaging time of Seg,bhCS and fbCS decreased successively[375.0(332.0,405.6)vs.50.0(47.8,53.7)vs.20.0(17.8,23.7)s,χ^(2)=48.00,P<0.001].The overall image quality of fbCS was slightly lower than that of Seg(Z=-2.67,P=0.023),and there was no difference between Seg and bhCS(Z=-1.44,P=0.447),bhCS and fbCS(Z=1.23,P=0.660).There were no differences in edge sharpness(χ^(2)=1.08,P=0.582)and BMC(χ^(2)=0.58,P=0.747)for three methods.Bland-Altman polts showed good agreement for biventricular functional measurements between bhCS and Seg,and between fbCS and Seg.All functional measurements of bhCS and fbCS were highly correlated with that of seg(r>0.96,P<0.001).Conclusions Compared with traditional sequences,CS ultrafast cine sequences can save scanning time and provide similar image quality.No matter whether breath holding or not,the cardiac functional results of CS sequence and traditional cine sequence have good agreement and high correlation.