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Satriano A, Heydari B, Narous M, Exner DV, Mikami Y, Attwood MM, Tyberg JV, Lydell CP, Howarth AG, Fine NM, White JA. Clinical feasibility and validation of 3D principal strain analysis from cine MRI: comparison to 2D strain by MRI and 3D speckle tracking echocardiography. Int J Cardiovasc Imaging 2017; 33:1979-1992. [PMID: 28685315 PMCID: PMC5698377 DOI: 10.1007/s10554-017-1199-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 06/22/2017] [Indexed: 11/29/2022]
Abstract
Two-dimensional (2D) strain analysis is constrained by geometry-dependent reference directions of deformation (i.e. radial, circumferential, and longitudinal) following the assumption of cylindrical chamber architecture. Three-dimensional (3D) principal strain analysis may overcome such limitations by referencing intrinsic (i.e. principal) directions of deformation. This study aimed to demonstrate clinical feasibility of 3D principal strain analysis from routine 2D cine MRI with validation to strain from 2D tagged cine analysis and 3D speckle tracking echocardiography. Thirty-one patients undergoing cardiac MRI were studied. 3D strain was measured from routine, multi-planar 2D cine SSFP images using custom software designed to apply 4D deformation fields to 3D cardiac models to derive principal strain. Comparisons of strain estimates versus those by 2D tagged cine, 2D non-tagged cine (feature tracking), and 3D speckle tracking echocardiography (STE) were performed. Mean age was 51 ± 14 (36% female). Mean LV ejection fraction was 66 ± 10% (range 37–80%). 3D principal strain analysis was feasible in all subjects and showed high inter- and intra-observer reproducibility (ICC range 0.83–0.97 and 0.83–0.98, respectively—p < 0.001 for all directions). Strong correlations of minimum and maximum principal strain were respectively observed versus the following: 3D STE estimates of longitudinal (r = 0.81 and r = −0.64), circumferential (r = 0.76 and r = −0.58) and radial (r = −0.80 and r = 0.63) strain (p < 0.001 for all); 2D tagged cine estimates of longitudinal (r = 0.81 and r = −0.81), circumferential (r = 0.87 and r = −0.85), and radial (r = −0.76 and r = 0.81) strain (p < 0.0001 for all); and 2D cine (feature tracking) estimates of longitudinal (r = 0.85 and −0.83), circumferential (r = 0.88 and r = −0.87), and radial strain (r = −0.79 and r = 0.84, p < 0.0001 for all). 3D principal strain analysis is feasible using routine, multi-planar 2D cine MRI and shows high reproducibility with strong correlations to 2D conventional strain analysis and 3D STE-based analysis. Given its independence from geometry-related directions of deformation this technique may offer unique benefit for the detection and prognostication of myocardial disease, and warrants expanded investigation.
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Affiliation(s)
- Alessandro Satriano
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Bobak Heydari
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Mariam Narous
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Derek V Exner
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Yoko Mikami
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada
| | - Monica M Attwood
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - John V Tyberg
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Carmen P Lydell
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Department of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada
| | - Andrew G Howarth
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Nowell M Fine
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - James A White
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada. .,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.
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Kar J, Knutsen AK, Cupps BP, Pasque MK. A validation of two-dimensional in vivo regional strain computed from displacement encoding with stimulated echoes (DENSE), in reference to tagged magnetic resonance imaging and studies in repeatability. Ann Biomed Eng 2013; 42:541-54. [PMID: 24150239 DOI: 10.1007/s10439-013-0931-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/15/2013] [Indexed: 01/23/2023]
Abstract
Fast cine displacement encoding with stimulated echoes (DENSE) has comparative advantages over tagged MRI (TMRI) including higher spatial resolution and faster post-processing. This study computed regional radial and circumferential myocardial strains with DENSE displacements and validated it in reference to TMRI, according to American Heart Association (AHA) guidelines for standardized segmentation of regions in the left ventricle (LV). This study was therefore novel in examining agreement between the modalities in 16 AHA recommended LV segments. DENSE displacements were obtained with spatiotemporal phase unwrapping and TMRI displacements obtained with a conventional tag-finding algorithm. A validation study with a rotating phantom established similar shear strain between modalities prior to in vivo studies. A novel meshfree nearest node finite element method (NNFEM) was used for rapid computation of Lagrange strain in both phantom and in vivo studies in both modalities. Also novel was conducting in vivo repeatability studies for observing recurring strain patterns in DENSE and increase confidence in it. Comprehensive regional strain agreements via Bland-Altman analysis between the modalities were obtained. Results from the phantom study showed similar radial-circumferential shear strains from the two modalities. Mean differences in regional in vivo circumferential strains were -0.01 ± 0.09 (95% limits of agreement) from comparing the modalities and -0.01 ± 0.07 from repeatability studies. Differences and means from comparison and repeatability studies were uncorrelated (p > 0.05) indicating no increases in differences with increased strain magnitudes. Bland-Altman analysis and similarities in regional strain distribution within the myocardium showed good agreements between DENSE and TMRI and show their interchangeability. NNFEM was also established as a common framework for computing strain in both modalities.
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Affiliation(s)
- Julia Kar
- Department of Surgery, School of Medicine, Washington University in St. Louis, 660 S. Euclid Ave., St Louis, MO, 63110, USA,
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Moerman KM, Sprengers AMJ, Simms CK, Lamerichs RM, Stoker J, Nederveen AJ. Validation of continuously tagged MRI for the measurement of dynamic 3D skeletal muscle tissue deformation. Med Phys 2012; 39:1793-810. [PMID: 22482602 DOI: 10.1118/1.3685579] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Typically spatial modulation of the magnetization (SPAMM) tagged magnetic resonance imaging (MRI) requires many repeated motion cycles limiting the applicability to highly repeatable tissue motions only. This paper describes the validation of a novel SPAMM tagged MRI and post-processing framework for the measurement of complex and dynamic 3D soft tissue deformation following just three motion cycles. Techniques are applied to indentation induced deformation measurement of the upper arm and a silicone gel phantom. METHODS A SPAMM tagged MRI methodology is presented allowing continuous (3.3-3.6 Hz) sampling of 3D dynamic soft tissue deformation using non segmented 3D acquisitions. The 3D deformation is reconstructed by the combination of three mutually orthogonal tagging directions, thus requiring only three repeated motion cycles. In addition a fully automatic post-processing framework is presented employing Gabor scale-space and filter-bank analysis for tag extrema segmentation and triangulated surface fitting aided by Gabor filter bank derived surface normals. Deformation is derived following tracking of tag surface triplet triangle intersections. The dynamic deformation measurements were validated using indentation tests (∼20 mm deep at 12 mm/s) on a silicone gel soft tissue phantom containing contrasting markers which provide a reference measure of deformation. In addition, the techniques were evaluated in vivo for dynamic skeletal muscle tissue deformation measurement during indentation of the biceps region of the upper arm in a volunteer. RESULTS For the phantom and volunteer tag point location precision were 44 and 92 μm, respectively resulting in individual displacements precisions of 61 and 91 μm, respectively. For both the phantom and volunteer data cumulative displacement measurement accuracy could be evaluated and the difference between initial and final locations showed a mean and standard deviation of 0.44 and 0.59 mm for the phantom and 0.40 and 0.73 mm for the human data. Finally accuracy of (cumulative) displacement was evaluated using marker tracking in the silicone gel phantom. Differences between true and predicted marker locations showed a mean of 0.35 mm and a standard deviation of 0.63 mm. CONCLUSIONS A novel SPAMM tagged MRI and fully automatic post-processing framework for the measurement of complex 3D dynamic soft tissue deformation following just three repeated motion cycles was presented. The techniques demonstrate dynamic measurement of complex 3D soft tissue deformation at subvoxel accuracy and precision and were validated for 3.3-3.6 Hz sampling of deformation speeds up to 12 mm/s.
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Affiliation(s)
- Kevin M Moerman
- Radiology Department, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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Knutsen AK, Ma N, Taggar AK, Brady BD, Cupps BP, Pasque MK. Heterogeneous distribution of left ventricular contractile injury in chronic aortic insufficiency. Ann Thorac Surg 2012; 93:1121-7. [PMID: 22381452 DOI: 10.1016/j.athoracsur.2011.12.067] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 12/22/2011] [Accepted: 12/28/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND Global systolic strain has been described previously in patients with chronic aortic insufficiency (AI). This study explored regional differences in contractile injury. METHODS Tagged magnetic resonance images of the left ventricle (LV) were acquired and analyzed to calculate systolic strain in 42 patients with chronic AI. Multiparametric systolic strain analysis was applied to relate cardiac function in AI patients to a normal strain database (N = 60). AI patients were classified as having normal or poor function based on their results. A two-way repeated-measures analysis of variance was applied to analyze regional differences in injury. RESULTS The mean and standard deviation of raw strain values (circumferential strain, longitudinal strain, and minimum principal strain angle) are presented over the entire LV in our normal strain database. Of the 42 patients with AI, 15 could be defined as having poor function by multiparametric systolic strain analysis. In AI patients with poor function, statistical analysis showed significant differences in injury between standard LV regions (F(3.69,44.33) = 3.47, p = 0.017) and levels (F(1.49,17.88) = 4.41, p = 0.037) of the LV, whereas no significant differences were seen in the group with normal cardiac function. CONCLUSIONS Patients with poor function, as defined by multiparametric systolic strain z scores, exhibit a consistent, heterogeneous pattern of contractile injury in which the septum and posterior regions at the base are most injured.
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Affiliation(s)
- Andrew K Knutsen
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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