Journal
JOURNAL OF MAGNETIC RESONANCE IMAGING
Volume 38, Issue 6, Pages 1369-1376Publisher
WILEY
DOI: 10.1002/jmri.24116
Keywords
magnetic resonance imaging; late gadolinium enhancement; visual quantification; quantitative analysis
Funding
- Clinician Scientist award with the Heart and Stroke Foundation of Ontario, Canada
- Career Scientist award from the Heart and Stroke Foundation of Ontario
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PurposeTo determine the accuracy and reproducibility of late gadolinium enhancement (LGE) MRI scar quantification using visual sub-segmental analysis (VSSA) versus signal threshold-based analysis in ischemic and nonischemic cardiomyopathy. Materials and MethodsOne-hundred sixty-one patients with abnormal LGE imaging underwent VSSA and signal threshold-based analysis. VSSA was performed using a 68 sub-segmental model. Signal threshold-based analysis was performed using cutoffs of 2, 3, and 5 standard deviations (SD) above the mean signal of normal myocardium. Comparison of VSSA and signal threshold-based analysis was performed by linear regression and Bland Altman plots. ResultsSeventy (44%) patients had ischemic scar, 76 (47%) had nonischemic scar, and 15 (9%) had a combined pattern. Correlation coefficients for VSSA versus signal threshold-based analysis at 2, 3, and 5SD thresholds were r = 0.63, r = 0.79, r = 0.81 (P < 0.001) for all patients, r = 0.74, r = 0.81, r = 0.81 (P < 0.001) in those with ischemic scar, and r = 0.46, r = 0.69, r = 0.72 (P < 0.001) in those with nonischemic scar. Bland Altman analysis revealed no significant bias in total scar volume among all patients (-4.3 7.9%), those with ischemic scar (-4.8 +/- 7.8%), or those with nonischemic scar (-2.6 +/- 7.6%). Intra-observer and inter-observer variability of the VSSA technique was excellent with a mean difference in total percent scar of 0.3% (-8.3-8.9%) and -0.4% (-9.5-8.5%), respectively. ConclusionA VSSA-based model of myocardial scar quantification is accurate and reproducible in ischemic and nonischemic cardiomyopathy.
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