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27.06.2017 | Cardiac | Ausgabe 12/2017 Open Access

European Radiology 12/2017

Strain analysis in CRT candidates using the novel segment length in cine (SLICE) post-processing technique on standard CMR cine images

Zeitschrift:
European Radiology > Ausgabe 12/2017
Autoren:
Alwin Zweerink, Cornelis P. Allaart, Joost P. A. Kuijer, LiNa Wu, Aernout M. Beek, Peter M. van de Ven, Mathias Meine, Pierre Croisille, Patrick Clarysse, Albert C. van Rossum, Robin Nijveldt
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00330-017-4890-0) contains supplementary material, which is available to authorized users.

Abstract

Objectives

Although myocardial strain analysis is a potential tool to improve patient selection for cardiac resynchronization therapy (CRT), there is currently no validated clinical approach to derive segmental strains. We evaluated the novel segment length in cine (SLICE) technique to derive segmental strains from standard cardiovascular MR (CMR) cine images in CRT candidates.

Methods

Twenty-seven patients with left bundle branch block underwent CMR examination including cine imaging and myocardial tagging (CMR-TAG). SLICE was performed by measuring segment length between anatomical landmarks throughout all phases on short-axis cines. This measure of frame-to-frame segment length change was compared to CMR-TAG circumferential strain measurements. Subsequently, conventional markers of CRT response were calculated.

Results

Segmental strains showed good to excellent agreement between SLICE and CMR-TAG (septum strain, intraclass correlation coefficient (ICC) 0.76; lateral wall strain, ICC 0.66). Conventional markers of CRT response also showed close agreement between both methods (ICC 0.61–0.78). Reproducibility of SLICE was excellent for intra-observer testing (all ICC ≥0.76) and good for interobserver testing (all ICC ≥0.61).

Conclusions

The novel SLICE post-processing technique on standard CMR cine images offers both accurate and robust segmental strain measures compared to the ‘gold standard’ CMR-TAG technique, and has the advantage of being widely available.

Key Points

• Myocardial strain analysis could potentially improve patient selection for CRT.
• Currently a well validated clinical approach to derive segmental strains is lacking.
• The novel SLICE technique derives segmental strains from standard CMR cine images.
• SLICE-derived strain markers of CRT response showed close agreement with CMR-TAG.
• Future studies will focus on the prognostic value of SLICE in CRT candidates.

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