Blood-threshold CMR volume analysis of functional univentricular heart
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To validate a blood-threshold (BT) segmentation software for cardiac magnetic resonance (CMR) cine images in patients with functional univentricular heart (FUH).
Materials and methods
We evaluated retrospectively 44 FUH patients aged 25 ± 8 years (mean ± standard deviation). For each patient, the epicardial contour of the single ventricle was manually segmented on cine images by two readers and an automated BT algorithm was independently applied to calculate end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and cardiac mass (CM). Aortic flow analysis (AFA) was performed on through-plane images to obtain forward volumes and used as a benchmark. Reproducibility was tested in a subgroup of 24 randomly selected patients. Wilcoxon, Spearman, and Bland–Altman statistics were used.
No significant difference was found between SV (median 57.7 ml; interquartile range 47.9–75.6) and aortic forward flow (57.4 ml; 48.9–80.4) (p = 0.123), with a high correlation (r = 0.789, p < 0.001). Intra-reader reproducibility was 86% for SV segmentation, and 96% for AFA. Inter-reader reproducibility was 85 and 96%, respectively.
The BT segmentation provided an accurate and reproducible assessment of heart function in FUH patients.
KeywordsCongenital heart disease Univentricular heart Cardiac magnetic resonance Ventricular function Image segmentation
This study was supported by local research funds of the IRCCS Policlinico San Donato, a Clinical Research Hospital partially funded by the Italian Ministry of Health.
Compliance with ethical standards
This article does not contain any studies with human participants or animals performed by any of the authors.
The Ethical Committee of IRCCS Ospedale San Raffaele approved the protocol UH_01 on July 14, 2016. Register 115/INT/2016.
Conflict of interest
F Secchi has been sponsored to congresses by Bracco Imaging SpA (Milan, Italy). F. Sardanelli is on the speaker’s bureau for Bracco Imaging SpA (Milan, Italy) and received research grants from Bayer Healthcare (Berlin, Germany)
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