Bildqualität und Funktionsanalyse von Real-Time-Herz-MRT-Untersuchungen bei 3,0 T: Volumetrie mit Vergleich zweier Softwareprototypen und Analyse der myokardialen Deformation im Sinusrhythmus und bei Vorhofflimmern

Image quality and functional analysis in Real-Time-CMR in 3.0 T: volumetry comparing two software prototypes and myoakardial deformation in sinus rhythm and atrial fibrillation

von Kerstin Laubrock
Dissertation
Datum der mündl. Prüfung:2020-11-19
Erschienen:2020-11-09
Betreuer:Prof. Dr. Christina Unterberg-Buchwald
Gutachter:Prof. Dr. Christina Unterberg-Buchwald
Gutachter:Prof. Dr. Dr. Andreas Schuster
Gutachter:Prof. Dr. Thomas Meyer
Zum Verlinken/Zitieren: http://dx.doi.org/10.53846/goediss-8283

 

 

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Name:Doktorarbeit Laubrock Stand 30.10.2020 ohne ...pdf
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Zusammenfassung

Englisch

Background: Myocardial stain offers an additive diagnostic and predictive factor in different cardiovascular diseases. While echocardiography is still the supreme cheap and most accessible method, CMR represents the more exact modality. However, in arrhythmia conventional CINE CMR is hampered by reconstruction artifacts caused by inconsistent data from multiple heartbeats. A rapid signal processing as Real-Time (RT) MRI at high temporal resolution might allow reliable analysis of deformation and volumetry during arrhythmia. Methods: A total of 30 patients with atrial fibrillation and 20 subjects in sinus rhythm were prospectively included and underwent 3.0 T RT and standard CINE CMR protocol. RT CMR acquisition was performed without cardiac gating and during free breathing, record multiple consecutive beats. Three consecutive RT beats and the corresponding CINE beat were used to determine single-layer longitudinal, circumferential and radial strain using CMR-FT software QStrain (Medis, Netherlands). Correlation of CINE and RT analysis was calculated using Pearson and Spearman method, moreover intra- and interobserver variability was tested. Additionally image quality and left ventricular volumetry was determined. Results: Single beat strain analysis was successfully performed in RT CMR of subjects with atrial fibrillation. Compared to the corresponding RT strain analysis, a higher proportion of CINE images showed insufficient tracking. Strain analysis of RT and CINE CMR showed a significant high correlation in both groups. In patients with atrial fibrillation RT CMR resulted in a mostly significantly higher image quality compared to CINE imaging, whereas during sinus rhythm conventional CINE images were superior concerning diagnostic quality. RT CMR resulted in slightly lower strain and functional values than CINE CMR. Conclusion: CINE CMR strain analysis in arrhythmic beats is error-prone. RT CMR improves image quality in arrhythmic patients, allowing a reliable FT strain analysis. Strain analysis as well as volumetric analysis is feasible with slightly lower values relative to CINE CMR. Until now, only single beat analysis is possible, to use the full potential of consecutive RT beats there is a need for a further development of post processing software.
Keywords: Real Time; CINE; Feature Tracking; CMR

Deutsch

Die Bewertung der kardialen Funktion einschließlich der myokardialen Deformation, zu Englisch Strain, ist fundamental für Behandlungsentscheidungen bei herzkranken Patienten und kann mit Hilfe der Magnet Resonanz Tomografie (MRT) zuverlässig durchgeführt werden. Allerdings führen Arrhythmien (z.B. Vorhofflimmern) bei herkömmlichen CINE bSSFP Sequenzen oftmals zu einer eingeschränkten Bildqualität und resultierend schlechteren Beurteilbarkeit der Herzfunktion. Die Real Time bSSFP Sequenz hingegen zeigt sich robust gegen Arrhythmie bedingte Artefakte und bietet zugleich mehrere Herzschläge für die Funktionsanalyse. Das Ziel dieser Studie war, die Durchführbarkeit und Vergleichbarkeit der kardialen MRT Strain Analyse an RT Aufnahmen von Probanden im Sinusrhythmus (SR) und Patienten im Vorhofflimmern (VHF) zu belegen.
Schlagwörter: Real Time; CMR; Feature Tracking; CINE
 
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