Evaluation of Cardiac Shunts With 4D Flow Cardiac Magnetic Resonance: Intra- and Interobserver Variability
| Autor: | José Angel Cabrera, Vicente Martinez de Vega, Javier Urmeneta Ulloa, Ana Alvarez Vazquez |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary Circulation
Magnetic Resonance Spectroscopy Correlation coefficient Imagen por resonancia magnética Population Enfermedad cardiovascular Heart Septal Defects Atrial 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Medicina preventiva medicine Humans Mean flow Radiology Nuclear Medicine and imaging education Tecnología médica Retrospective Studies Observer Variation education.field_of_study medicine.diagnostic_test business.industry Cardiac shunt Magnetic resonance imaging Magnetic Resonance Imaging medicine.anatomical_structure Ventricle Nuclear medicine business Cardiac magnetic resonance Shunt (electrical) Cardiopatías |
| Popis: | Background: In the last decade, the capacity of magnetic resonance (MR) to evaluate congenital anomalies has improved substantially. To date, only a few studies have evaluated the value of 4D-flow MRI in shunt assessments. Purpose/hypothesis: To assess the intra- and interobserver variability of 4D-flow MRI in patients diagnosed with cardiac/extracardiac shunt. Secondarily, to assess the feasibility of directly measuring the shunt and to determine the prognostic correlation with the pulmonary-to-systemic (Qp/Qs) flow ratio. Study type: Retrospective. Population: In all, 18 patients with cardiac shunt diagnosis. Field strength/sequence: 1.5 T/4D phase-contrast MRI. Assessment: Pulmonary and systemic flows were measured at different locations to assess the internal consistency by two observers (twice by one, and once by the other). The Qp/Qs ratio was calculated. When feasible, direct flow was quantified by planimetry. Statistical tests: Spearman's rho correlation coefficient was used to assess the relationship between pulmonary/systemic flows measured at different levels and to compare the jet characteristics with prognostic data as right ventricle volume. Intra- and interobserver variability were determined by Bland-Altman plots and interobserver correlation. Results: The most common shunt type (n = 10; 55.5%) was ostium secundum atrial septal defect (ASD). Direct visualization and quantification of shunt flow was possible in all studies. Pulmonary and systemic flows showed a strong correlation between these measures (Spearman's rho [r] of 0.872 and 0.899). The mean Qp/Qs ratio was 1.61(0.62). Mean flow rate was 2.01(1.68) l/min. The mean jet diameter was 11.88 (5.44) mm. Intraobserver (r = 0.97) and interobserver correlation (ICC = 0.95) for the Qp/Qs calculation were both excellent. Direct measurement of flow was strongly correlated (r = 0.98; ICC = 0.95). Correlation was strong between Qp/Qs and direct jet flow (r = 0.76 and 0.77), Qp/Qs and mean jet diameter (r = 0.79 and 0.94), and Qp/Qs with jet area (r = 0.77 and 0.94). Data conclusion: Measurement of the Qp/Qs ratio and direct shunt quantification using 4D-flow MRI was feasible, and highly reproducible. Internal consistency was excellent, with low intra- and interobserver variability. Correlation between the Qp/Qs ratio, direct flow measurement, mean diameter, and jet area was strong. Evidence level: 3 TECHNICAL EFFICACY: Stage 2 J. Magn. Reson. Imaging 2020;52:1055-1063. Sin financiación 4.813 JCR (2020) Q2, 26/133 Radiology, Nuclear Medicine & Medical Imaging 1.563 SJR (2020) Q1, 29/338 Radiology, Nuclear Medicine and Imaging No data IDR 2020 UEM |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|