Abstract
The acquisition of short-axis (SA) cine magnetic resonance (MR) images after the administration of contrast agent (CA) is a common, time-saving technique, but a decreased difference in the blood-myocardium contrast on these steady-state free precession (SSFP) cine scans could change the calculated parameters when using threshold-based papillary and trabecular muscle (PTM) quantification. We studied the effect of CA on the parameters calculated from pre- and post-CA SA cine images in noncompaction cardiomyopathy (NC-CMP) and healthy (H) participants using a threshold-based module. A total of 39 individuals (20 patients and 19 healthy) were included prospectively in this study. After the pre-CA SA images were acquired, i.v. gadobutrol (GA) or gadobenate dimeglumine (GD) (GA vs. GD: NC-CMP = 12 vs. 8; C = 12 vs. 7) was administered, and SA scans were repeated after two minutes. A threshold-based PTM software was used for postprocessing. Pre-CA and post-CA SA images were analyzed, and the parameters were compared in both the NC-CMP and H groups. The left ventricular volumes were significantly larger, while the left ventricular myocardial (LVmass) and trabecular mass (LVtrab) values were significantly smaller on the post-CA scans (NC-CMP: pre-CA vs. post-CA, EDV: 74.0 ± 13.6 vs. 81.1 ± 16.3 ml/m2, ESV: 25.3 ± 7.3 vs. 30.1 ± 11.2 ml/m2, LVmass-ED: 82.5 ± 17.5 vs. 75.7 ± 15.9 g/m2, LVtrab-ED: 25.0 ± 6.6 vs. 18.9 ± 4.7 g/m2; Healthy: preCA vs. post-CA, EDV: 69.7 ± 11.9 vs. 72.2 ± 10.7 ml/m2, ESV: 22.6 ± 5.7 vs. 23.9 ± 6.3 ml/m2, LVmass-ED: 71.3 ± 13.6 vs. 68.7 ± 13.9 g/m2, LVtrab-ED: 19.4 ± 2.6 vs. 16.2 ± 3.0 g/m2; p < 0.05). The decreased blood-myocardium contrast difference on post-CA SSFP SA cine images leads to altered cardiac parameters when using threshold-based software for evaluation.
Highlights
Postprocessing software has been developing continuously since cardiac magnetic resonance (CMR) imaging was first performed; the currently available techniques are more user-friendly and are able to provide gold-standard data on Andrea Szűcs and Anna Réka Kiss have contributed to this work.1 3 Vol.:(0123456789)The International Journal of Cardiovascular Imaging (2019) 35:1683–1689 is excellent and independent of the experience of the observers [6].Noncompaction cardiomyopathy (NC-CMP) is a rare disorder caused by the failure of myocardial compaction during embryogenesis and results in excessive trabeculation, mainly in the apical part of the left ventricle
We compared the parameters calculated from the preCA and post-contrast agent (CA) scans both in the noncompaction cardiomyopathy (NC-CMP) and healthy groups and found significant differences in the left ventricular parameters; the end-diastolic volume (EDV) and end-systolic volume (ESV) were significantly larger, and the left ventricular myocardial mass and trabecular mass were significantly smaller on the post-CA scans in both groups (Table 2)
The values of the post-CA parameters were subtracted from the values of the pre-CA parameters, and the absolute values were used to compare the differences between the pre- and post-CA parameters of the two groups; the difference between the scans was significantly larger in the NC-CMP group than in the healthy normal group (NC-CMP difference vs. healthy normal difference: EDV, 7.9 ± 6.0 vs. 3.3 ± 3.3 ml/m2; ESV, 5.4 ± 6.3 vs. 2.0 ± 2.1 ml/m2; ejection fraction (EF), 3.3 ± 2.7 vs. 2.3 ± 2.7%; LVmassED, 7.0 ± 4.8 vs. 3.3 ± 2.1 g/m2; LVtrab-ED, 6.0 ± 3.9 vs. 3.2 ± 1.7 g/m2; p < 0.005)
Summary
Postprocessing software has been developing continuously since cardiac magnetic resonance (CMR) imaging was first performed; the currently available techniques are more user-friendly and are able to provide gold-standard data on Andrea Szűcs and Anna Réka Kiss have contributed to this work. Noncompaction cardiomyopathy (NC-CMP) is a rare disorder caused by the failure of myocardial compaction during embryogenesis and results in excessive trabeculation, mainly in the apical part of the left ventricle. The clinical significance of this disease is controversial; in many cases, left ventricle noncompaction ends in dilated cardiomyopathy and heart failure, but patients can remain symptomless with good left ventricular ejection fraction values [7]. Endocardial trabeculation is harder to visualize on these scans because the CA alters the signal intensity of the blood pool and the myocardium on SSFP images, decreasing the difference between them. The significance of this effect on the precision of another type of CMR analytical software, namely, feature tracking, has been reported in the literature [11]
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