Document Detail


Hypertrophic cardiomyopathy: quantification of late gadolinium enhancement with contrast-enhanced cardiovascular MR imaging.
MedLine Citation:
PMID:  21045187     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the most reproducible semiautomated gray-scale thresholding technique for quantifying late gadolinium enhancement (LGE) in a large cohort of patients with hypertrophic cardiomyopathy (HCM).
MATERIALS AND METHODS: All study patients signed a statement approved by the internal review boards of the participating institutions, agreeing to the use of their medical information for research purposes. LGE cardiovascular magnetic resonance (MR) imaging was performed in 201 patients (71% male) with a mean age of 41.5 years ± 17.6 (standard deviation [SD]) by using standard techniques with administration of 0.2 mmol of gadopentetate dimeglumine per kilogram of body weight. The presence and quantity of LGE were determined first with visual assessment; then with gray-scale thresholds of 2 SDs, 4 SDs, and 6 SDs above the mean signal intensity for the normal remote myocardium; and then with 2 SDs above noise. The LGE quantifications were repeated 4 or more weeks apart to assess reproducibility. Bland-Altman analysis and correlation coefficients were used to compare the visual and various thresholding methods, with normally distributed variables expressed as means ± SDs.
RESULTS: LGE was identified in 103 (51%) subjects. The mean quantity of LGE at visual analysis was 13 g ± 20 compared with 12 g ± 17 at 6 SDs, 25 g ± 23 at 4 SDs, 55 g ± 31 at 2 SDs, and 64 g ± 69 at 2 SDs above noise. All gray-scale thresholds were significantly correlated with visual assessment. The 6-SD threshold had the strongest correlation (r = 0.913, P < .0001) compared with thresholds of 2 SDs (r = 0.81) and 4 SDs (r = 0.91) above the mean and 2 SDs above noise (r = 0.53) (P < .001 for all comparisons). In addition, compared with visual assessment, the 6-SD threshold yielded less intraobserver variability (difference, 0.6 g ± 8, κ = 0.66 [P < .0001] vs 1.4 g ± 9, κ = 0.49 [P < .0001]) and less interobserver variability (difference, 5.4 g ± 18, κ = 0.20 [P < .0001] vs -18.4 g ± 18, κ = 0.08 [P < .0001]).
CONCLUSION: Semiautomated LGE cardiovascular MR gray-scale thresholding with 6 or more SDs above the mean signal intensity for the visually normal remote myocardium yields the closest approximation of the extent of LGE identified with visual assessment and is highly reproducible. This objective method should be considered for quantifying LGE in patients with HCM.
Authors:
Caitlin J Harrigan; Dana C Peters; C Michael Gibson; Barry J Maron; Warren J Manning; Martin S Maron; Evan Appelbaum
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Publication Detail:
Type:  Journal Article     Date:  2010-11-02
Journal Detail:
Title:  Radiology     Volume:  258     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  128-33     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2010
Affiliation:
PERFUSE Core Laboratories and Data Coordinating Center, Beth Israel Deaconess Medical Center, Harvard Medical School, RW 453 East Campus, 330 Brookline Ave, Boston, MA 02215, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiomyopathy, Hypertrophic / pathology*
Chi-Square Distribution
Contrast Media / diagnostic use*
Female
Gadolinium DTPA / diagnostic use*
Humans
Image Enhancement / methods
Magnetic Resonance Imaging / methods*
Male
Reproducibility of Results
Retrospective Studies
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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