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. 2016 Aug;17(8):909-17.
doi: 10.1093/ehjci/jev215. Epub 2015 Sep 10.

Reproducibility of functional aortic analysis using magnetic resonance imaging: the MESA

Chikara Noda  1 , Bharath Ambale Venkatesh  2 , Yoshiaki Ohyama  1 , Chia-Ying Liu  3 , Elzbieta Chamera  1 , Alban Redheuil  4 , Gisela Teixido-Tura  5 , Atul R Chugh  6 , Colin O Wu  7 , Gregory W Hundley  8 , David A Bluemke  3 , Joao A C Lima  9
Affiliations

Reproducibility of functional aortic analysis using magnetic resonance imaging: the MESA

Chikara Noda et al. Eur Heart J Cardiovasc Imaging. 2016 Aug.

Abstract

Aims: To assess the test-retest, intra- and inter-reader reliability of thoracic aorta measurements by magnetic resonance imaging (MRI).

Methods and results: Twenty-five participants underwent aortic MRI twice over 13 ± 7 days. All aortic variables from baseline and repeat MR were analysed using a semi-automated method by the ARTFUN software. To assess the inter-study reproducibility of aortic variables, we calculated intraclass correlation coefficient (ICC) for individual aortic measurements. Intra- and inter-observer variability was also assessed using the baseline MR data. Mean ascending aortic strain had moderate inter-study reproducibility (11.53 ± 6.44 vs. 10.55 ± 6.64, P = 0.443, ICC = 0.53, P < 0.01). Mean descending aortic strain and arch pulse wave velocity (PWV) had good inter-study reproducibility (descending aortic strain: 8.65 ± 5.30 vs. 8.35 ± 5.26, P = 0.706, ICC = 0.74, P < 0.001; PWV: 9.92 ± 4.18 vs. 9.94 ± 4.55, P = 0.968, ICC = 0.77, P < 0.001, respectively). All aortic variables had excellent intra- and inter-observer reproducibility (intra-: ICC range, 0.87-0.99, inter-: ICC range, 0.56-0.99, respectively).

Conclusion: Inter-study reproducibility of all aortic variables was acceptable. Intra- and inter-observer reproducibility of all aortic variables was excellent. MRI can provide a repeatable method of measuring aortic structural and functional parameters.

Keywords: MRI; aorta; phase contrast; pulse wave velocity; reproducibility; strain.

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Figures

Figure 1
Figure 1
Aortic strain assessment with MRI. (A) Automatic tracking of aortic contour. (B) Temporal curve of aortic area obtained after automatic tracking.
Figure 2
Figure 2
Aortic arch PWV method. (A) Transit time (Δt) method of peak flow between ascending and descending aortic location. Before peak flow normalization (upper) and after peak flow normalization (lower). Δt was estimated as the time shift providing the highest correlation between ascending and descending aortic velocity. (B) Measurement of the transit distance (D) in the aortic arch. Aortic arch view (upper) and PC cine transverse view (lower) on MRI.
Figure 3
Figure 3
Reproducibility of ascending aortic strain: Bland–Altman plot (upper) and Passing–Bablok regression (lower); SD, standard deviation. (A) Intra-observer. (B) Inter-observer. (C) Inter-study.
Figure 4
Figure 4
Reproducibility of descending aortic strain: Bland–Altman plot (upper) and Passing–Bablok regression (lower); SD, standard deviation. (A) Intra-observer. (B) Inter-observer. (C) Inter-study.
Figure 5
Figure 5
Reproducibility of aortic arch PWV: Bland–Altman plot (upper) and Passing–Bablok regression (lower); SD, standard deviation. (A) Intra-observer. (B) Inter-observer. (C) Inter-study.
Figure 6
Figure 6
Assessment of slice location difference. (A) Method of measuring VD. (B) Correlation plot of slice location difference and aortic strain change. Delta strain (Exam 2 – Exam 1) and VD were calculated by initial scan minus repeat scan.
Figure 7
Figure 7
Reproducibility of aortic arch area and strain in under sampling: Difference = original – undersampled. SD, standard deviation; aa, ascending aorta; da, descending aorta. (A) Aortic area in standard vs. 50% reduction in in-plane resolution. (B) Aortic strain in standard vs. 50% reduction in in-plane resolution. (C) Aortic area in 30 images per beat vs. 15 images per beat. (D) Aortic strain in 30 images per beat vs. 15 images per beat.
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