Radial steady-state free precession MR imaging showed high agreement with breath-hold MR for wall motion scoring (kappa 0.89), outperforming spiral MR (kappa 0.67) and echocardiography (kappa 0.47).
Cross-Sectional (n=35)
Does interactive real-time cardiac MR imaging (spiral or radial sequences) provide comparable image quality and wall motion assessment to breath-hold cine MR imaging and echocardiography in patients scheduled for routine ECHO?
A radial steady-state free precession real-time MRI sequence provides regional wall motion assessment comparable to breath-hold cine MRI and superior to spiral MRI and echocardiography.
Effect estimate: Cohen kappa 0.89 (radial), 0.67 (spiral), 0.47 (ECHO)
p-value: p=<.0001
PURPOSE: To compare a spiral gradient-echo sequence with a radial steady-state free precession sequence and to compare these two interactive real-time cardiac magnetic resonance (MR) imaging examinations with harmonic two-dimensional echocardiography (ECHO) for the evaluation of regional myocardial function. MATERIALS AND METHODS: Electrocardiographically triggered breath-hold steady-state free precession (BH-SSFP) MR imaging was the reference standard. Thirty-five nonselected patients scheduled for routine ECHO were included. Data from corresponding two-, three-, and four-chamber long-axis views and a midventricular short-axis view were acquired with each modality. Image quality and depiction of segmental wall motion were scored semiquantitatively by using the 16-segment model of the American Society of Echocardiography. Repeated-measures analysis of variance was performed to assess differences in image quality and wall motion depiction scores among the four imaging methods. Agreement was assessed by using Cohen kappa statistics. RESULTS: Compared with the image quality achieved with BH-SSFP MR imaging, the image quality achieved with radial MR imaging was similar (nonsignificant difference), but that achieved with spiral MR imaging and ECHO was significantly inferior (P <.0001). There were no significant differences in the image quality of the long- and short-axis views between the radial and BH-SSFP sequences, while the image quality of the long-axis spiral (P <.05) and the short- and long-axis ECHO (P <.0001) views was lower than that of the BH-SSFP views. Compared with the mean wall motion score for BH-SSFP MR imaging, the mean wall motion score for radial MR imaging was not significantly different, but those for ECHO (P <.05) and spiral MR imaging (P =.0003) were significantly lower. Cohen kappa coefficients for agreement with the BH-SSFP sequence regarding wall motion scoring were 0.47 for ECHO, 0.67 for the spiral sequence, and 0.89 for the radial sequence. CONCLUSION: The radial sequence enables similar accurate assessment of regional wall motion compared with the BH-SSFP sequence and yields image quality that is superior to that yielded by the spiral sequence and ECHO.
Kühl et al. (Thu,) conducted a cross-sectional in Scheduled for routine echocardiography (n=35). Radial steady-state free precession and spiral gradient-echo real-time MR imaging vs. Harmonic two-dimensional echocardiography (ECHO) and breath-hold steady-state free precession (BH-SSFP) MR imaging was evaluated on Image quality and agreement with BH-SSFP sequence regarding wall motion scoring (Cohen kappa 0.89 (radial), 0.67 (spiral), 0.47 (ECHO), p=<.0001). Radial steady-state free precession MR imaging showed high agreement with breath-hold MR for wall motion scoring (kappa 0.89), outperforming spiral MR (kappa 0.67) and echocardiography (kappa 0.47).