Automated left ventricular diastolic function evaluation from phase-contrast cardiovascular magnetic resonance and comparison with Doppler echocardiography

International audienceBACKGROUND: Early detection of diastolic dysfunction is crucial for patients with incipient heart failure. Although this evaluation could be performed from phase-contrast (PC) cardiovascular magnetic resonance (CMR) data, its usefulness in clinical routine is not yet established, mainly because the interpretation of such data remains mostly based on manual post-processing. Accordingly, our goal was to develop a robust process to automatically estimate velocity and flow rate-related diastolic parameters from PC-CMR data and to test the consistency of these parameters against echocardiography as well as their ability to characterize left ventricular (LV) diastolic dysfunction. RESULTS: We studied 35 controls and 18 patients with severe aortic valve stenosis and preserved LV ejection fraction who had PC-CMR and Doppler echocardiography exams on the same day. PC-CMR mitral flow and myocardial velocity data were analyzed using custom software for semi-automated extraction of diastolic parameters. Inter-operator reproducibility of flow pattern segmentation and functional parameters was assessed on a sub-group of 30 subjects. The mean percentage of overlap between the transmitral flow segmentations performed by two independent operators was 99.7 ± 1.6%, resulting in a small variability ( 0.71) and receiver operating characteristic (ROC) analysis revealed their ability to separate patients from controls, with sensitivity > 0.80, specificity > 0.80 and accuracy > 0.85. Slight superiority in terms of correlation with echocardiography (r = 0.81) and accuracy to detect LV abnormalities (sensitivity > 0.83, specificity > 0.91 and accuracy > 0.89) was found for the PC-CMR flow-rate related parameters. CONCLUSIONS: A fast and reproducible technique for flow and myocardial PC-CMR data analysis was successfully used on controls and patients to extract consistent velocity-related diastolic parameters, as well as flow rate-related parameters. This technique provides a valuable addition to established CMR tools in the evaluation and the management of patients with diastolic dysfunction

Automated, Accurate and Fast Segmentation of 4D Cardiac MR Images

International audienc

An open, clinically-validated database of 3D+t cine-MR images of the left ventricle with associated manual and automated segmentation

electronic version (9 pp.)International audienc

Segmentation of 4D cardiac MRI: automated method based on spatio-temporal watershed cuts

International audienc

Right Ventricular Diastolic Function Evaluation in Magnetic Resonance Imaging

International audienceAlthough few studies demonstrated the ability of MRI dynamic anatomical sequences to assess right ventricular (RV) diastolic function, no data are available for velocityencoded MRI (VE-MRI). Accordingly, our aim was to evaluate RV diastolic function from VE-MRI, as compared to reference Doppler echocardiography. We studied 109 healthy individuals (67 men, age: 42±15 years) who underwent RV Doppler echocardiography and MRI, on the same day. VE-MRI images were analyzed using custom software, providing: tricuspid flow early peak velocity (E,cm/s) and flow-rate (Ef,ml/s), atrial peak velocity (A,cm/s) and flow-rate (Af,ml/s), longitudinal myocardial early peak velocity (E

Right ventricular diastolic function in aging: a head-to-head comparison between phase-contrast MRI and Doppler echocardiography

International audienceTo evaluate right ventricle (RV) diastolic function from phase-contrast MRI (PC-MRI) in aging. 89 healthy individuals (50 men, 43 ± 15 years) underwent cardiac MRI including 2D PC-MRI (1.5T) and reference Doppler echocardiography of both ventricles on the same day. Conventional echocardiographic parameters were estimated: early (E, cm/s) and atrial (A) peak velocities as well as myocardial early peak longitudinal velocity (E'). PC-MRI images were analyzed using custom software, providing: E', E and A waves along with respective peak flow rates (Ef, Af, mL/s) and filling volume (mL), for both ventricles. Intra- and inter-observer reproducibility was studied in 30 subjects and coefficients of variation (CoV) as well as intra-class correlation coefficients (ICC) were provided. RV diastolic function indices derived from PC-MRI data were reproducible (CoV ≤ 21%, ICC ≥ 0.75) and reliable as reflected by significant associations with left ventricular diastolic function indices assessed using both echocardiography (linear regression Pearson correlation coefficient r ≤ 0.59) and PC-MRI (r ≤ 71). Despite the fair associations between RV echocardiography and PC-MRI (r ≤ 0.25), the highest correlation with age was obtained for MRI Ef/Af ratio (r = - 0.64, p < 0.0001 vs. r = - 0.40, p = 0.0001 for echocardiographic E/A). Among PC-MRI E/A ratios, highest correlations with age were observed for flow rate and mean velocity ratios (r = - 0.61, p < 0.0001) as compared to maximal velocity ratios (r = - 0.56, p < 0.0001). Associations with age for E' were equivalent between PC-MRI (mean velocity: r = - 0.40, p < 0.0001; maximal velocity: r = - 0.36, p = 0.0005) and echocardiography (r = - 0.36, p = 0.0006). Finally, the significant and age-independent associations between RV mass/end-diastolic volume and E' were stronger for PC-MRI (mean velocity: r = - 0.36, p = 0.0006; maximal velocity: r = - 0.28, p = 0.007) than echocardiography (r = - 0.09, p = 0.38). PC-MRI tricuspid inflow and annulus myocardial velocity parameters were reproducible and able to characterize age-related variations in RV diastolic function

Fully automated segmentation of 4D cardiac cine-MRI dataset in humans

National audienc

Accurate assessment of left ventricular function in infarct patients with fully automated 4D segmentation of complete short-axis cine-MRI dataset

International audienc

Automated Evaluation of Diastolic Function from Phase-Contrast MRI in Healthy Subjects and Patients

International audienceEarly detection of diastolic dysfunction is crucial for patients with incipient heart failure. Our goal was to develop a robust process to automatically estimate diastolic parameters from phase-contrast cardiovascular magnetic resonance (PC-CMR) data and to test their ability to characterize left ventricular (LV) dysfunction. We studied 53 subjects (35 controls and 18 patients with a severe aortic valve stenosis) who had PC-CMR and Doppler echocardiography on the same day. PC-CMR data were analyzed using custom software to extract diastolic parameters. Our technique was reproducible, as reflected by a small variability (0.71) and were able to accurately separate patients from controls (accuracy>0.85). Of note, a superiority in terms of correlation with echocardiography and accuracy to detect LV abnormalities were found for flow-rate parameters. A fast and reproducible technique was proposed and was successfully used to extract consistent PC-CMR diastolic parameters. This technique provides a valuable addition to established CMR tools in evaluation of patients with diastolic dysfunction