Reproducibility of global and segmental myocardial strain using cine DENSE at 3 T: a multicenter cardiovascular magnetic resonance study in healthy subjects and patients with heart disease

Fig. 1. Demonstrations of intra-user and inter-user-same-site reproducibility. Example end-systolic short-axis displacement encoding with stimulated echoes (DENSE) magnitude (A) and phase (E) images of a healthy subject and the corresponding displacement maps (B, F), Ecc maps (C, G), and segmental circumferential strain (Ecc)-time curves (D, H) resulting from analysis by the same user at two different times (B, C, D vs. F, G, H). Also shown are example end-systolic long-axis DENSE magnitude (I) and phase (M) images of a healthy subject and the corresponding displacement maps (J, N), Ell maps (K, O), and global longitudinal strain (Ell)-time curves (L, P) resulting from analysis by two different users from the same site (J, K, L vs. N, O, P)

Fig. 2. Demonstration of inter-user-different-site reproducibility. Example end-systolic short-axis DENSE magnitude (A) and phase (E) images of a patient with heart failure and left bundle branch block are shown as are the corresponding displacement maps (B, F), Ecc maps (C, G), and segmental Ecc-time curves (D, H) resulting from analysis by users at two different sites (B, C, D vs. F, G, H)

Fig. 3. Bland–Altman plots for whole-slice or global Ecc, Ell, radial strain (Err) and torsion showing agreement of intra-user, inter-user-same-site, inter-user-different-site, inter-user-Human-DL and inter-scan comparisons

Fig. 4. Bland–Altman plots for segmental Ecc, showing agreement of intra-user, inter-user-same-site, inter-user-different-site, inter-user-Human-DL and inter-scan comparisons

Fig. 5. Bull’s eye plots of the coefficient of variation for segmental Ecc for intra-user, inter-user-same-site, inter-user-different-site, inter-user-human-DL and inter-scan comparisons

Fig. 6. Bull’s eye plots of the intraclass correlation coefficient for segmental Ecc for intra-user, inter-user-same-site, inter-user-different-site, inter-user-human-DL and inter-scan comparisons