Quantitative assessment of LV function and volumes with 3-slice segmentation of cine SSFP short axis images: our experience

Abstract

We retrospectively studied 1.5T cardiac MR images of 62 patients with various clinical indications. All patients had a stack of EKG gated segmented SSFP cine images through the LV. Semi-automated cardiac MR software (Argus) was used to trace LV contours both at multiple slices from base to apex as well as just 3 slices (base, mid and apical) by two readers. End diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) were calculated using both assessment methods. Results There were no statistically significant differences between EF and LV volumes obtained by multi-slice vs 3-slice analysis for both readers (P > 0.05). For reader 1 (and 2), Bland-Altman plot revealed the mean difference in LVEF between multi-slice and 3-slice analysis was 0.4% (0.5%) with limits of agreement of -4.3% to 5.1% (-3.9% to 4.9%) (Figure 1). For both readers, all differences in EF between multi-slice and 3-slice analysis were within 5.3%. The measured volumes are listed in Table 1. Multi-slice assessment required approximately 10 minutes per study while 3-slice evaluation required about 3-5 minutes. Conclusions The LVEF obtained from either 3-slice or multi-slice evaluation of SSFP cine images closely correlate across various cardiac pathologies, thereby offering a method to reduce post-processing time. Of note, although the decreased LV volumes obtained by 3-slice segmentation are statistically significant, the difference of < 3.7% may not be clinically significant. Funding None.