Cardiac magnetic resonance left ventricular quantitative analysis post gadolinium: reliable and reproducible?
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KeywordsCardiovascular Magnetic Resonance Gadolinium Contrast Post Contrast Short Axis Cine Left Ventricular Parameter
To assess the accuracy of left ventricular (LV) functional analysis derived from short axis steady-state free procession (SSFP) cine sequences following the administration of gadolinium contrast.
13 patients, with a variety of clinical indications, undergoing cardiac MRI requiring gadolinium contrast enhancement had pre and post contrast SSFP short axis cine acquisitions obtained. All images were acquired using a Siemens 1.5T Avanto MRI scanner. The same radiographer acquired pre and post contrast short axis stacks using identical parameters and without patient repositioning.
Post processing was performed using Siemens Argus software for evaluation of left ventricular parameters including end diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and mass. All data sets were analysed by three independent reporters.
Mean differences were compared using a 2-tailed paired t-test. Bland-Altman analysis was performed to assess inter-observer agreement. Values are quoted ± one standard deviation.
Combined mean LV volume measurements by all observers for all subjects.
Mean EDV (ml)
Mean ESV (ml)
Mean SV (ml)
Mean LV Mass (g)
Mean EF (%)
Mean difference in EF pre and post gadolinium was 0.5±6.9%.
Bland-Altman analysis of inter-observer LV parameters demonstrates a mean difference in EDV pre gadolinium of 1.4±13.0 ml, post gadolinium of 2.9±13.3ml and in ESV pre gadolinium of 6.0±12.4 ml and post gadolinium of 1.5 ml±6.1.
No significant difference between pre and post gadolinium assessment of LV parameters has been demonstrated. Despite the small sample size this suggests that use of post gadolinium data in LV analysis represents reasonable practice in a variety of patient groups.
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