Doppler Ultrasound Gating for Adult Cardiovascular Magnetic Resonance: Initial Experience.

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2025-02-13 DOI:10.1016/j.jocmr.2025.101862

Lucia D Beissel, Fabian Kording, Christian Ruprecht, Alexander Isaak, Thomas M Vollbrecht, Claus C Pieper, Daniel Kuetting, Abdulamir Ali, Pia Wölfl, Christopher Hart, Julian A Luetkens

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引用次数: 0

Abstract

Background: Despite of being a common gating method for cardiovascular magnetic resonance (CMR), electrocardiogram (ECG) gating has its disadvantages and new gating strategies are desirable. An alternative CMR gating method is doppler ultrasound (DUS) gating, which detects blood flow and ventricular movement. The aim of this study was to prove the feasibility of DUS gating as a novel CMR gating method in a clinical patient population.

Methods: In this prospective study, patients underwent clinically indicated CMR. Balanced steady-state free precession two-dimensional (2D) cine sequences in short axis and 4-chamber views were acquired using ECG and DUS gating. DUS and ECG signal were recorded simultaneously. Time difference between R wave and DUS systolic trigger detection was defined as trigger delay, the standard deviation of trigger delays as trigger jitter. Left and right ventricular parameters were assessed: Left and right ventricular ejection fraction (LVEF, RVEF) and left and right ventricular end-diastolic volume index (LVEDVI, RVEDVI). Overall image quality was assessed using a 5-point Likert scale (5=excellent to 1=non-diagnostic). For statistical analysis, paired t-test, Wilcoxon test, Pearson Correlation and intraclass correlation coefficient (ICC) were employed.

Results: 21 patients (7 female) were included (age: 45.4±19.7 years; body mass index: 27.6±5.5kg/m²). DUS mean trigger delay was 128±28ms. DUS mean trigger jitter was 23±13ms. Overall image quality showed no difference between ECG and DUS gating (e.g., short axis: 5 [IQR 3-5] vs. 4 [IQR 3.5-5]; P=0.21). Quantitative analysis revealed no differences between ECG and DUS gating: LVEF (53.2±9.2% vs. 52.3±9.1%; P=0.18; ICC 0.97 [95% confidence interval [CI] 0.93-0.99]), LVEDVI (84.5±15.8ml/m² vs. 83.3±15.8ml/m²; P=0.06; ICC 0.99 [95% CI 0.98-1.00]), RVEF (52.8±8.0% vs. 51.6±7.2%; P=0.06; ICC 0.96 [95% CI 0.89-0.99]) and RVEDVI (80.8±17.6ml/m² vs. 80.9±16.5ml/m²; P=0.91; ICC 0.98 [95% CI 0.96-0.99]). In one patient with a prominent lingula of the lung image quality non-diagnostic with DUS gating.

Conclusion: CMR gating with DUS is feasible and can offer an equivalent performance to ECG regarding image quality and quantitative parameter assessment.

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成人心血管磁共振多普勒超声门控：初步经验。

背景：尽管是心血管磁共振（CMR）常用的门控方法，但心电图（ECG）门控有其缺点，需要新的门控策略。另一种CMR门控方法是多普勒超声（DUS）门控，它可以检测血流和心室运动。本研究的目的是证明DUS门控作为一种新的CMR门控方法在临床患者群体中的可行性。方法：在这项前瞻性研究中，患者接受临床指示的CMR。利用ECG和DUS门控获得平衡的稳态自由进动二维（2D）短轴和四腔视图。同时记录DUS和心电信号。定义R波与DUS收缩期触发检测的时间差为触发延迟，触发延迟的标准差为触发抖动。评估左、右心室参数：左、右心室射血分数（LVEF， RVEF）和左、右心室舒张末期容积指数（LVEDVI， RVEDVI）。使用5点李克特量表（5=优秀至1=非诊断性）评估整体图像质量。统计分析采用配对t检验、Wilcoxon检验、Pearson相关和类内相关系数（ICC）。结果：纳入21例患者（女性7例），年龄：45.4±19.7岁；身体质量指数：27.6±5.5kg/m2)。DUS平均触发延迟为128±28ms。DUS平均触发抖动为23±13ms。整体图像质量显示ECG和DUS门控之间没有差异(例如，短轴：5 [IQR 3-5] vs. 4 [IQR 3.5-5]；P = 0.21)。定量分析显示ECG与DUS门控无差异：LVEF(53.2±9.2% vs. 52.3±9.1%)；P = 0.18;ICC 0.97[95%可信区间[CI] 0.93-0.99])， LVEDVI(84.5±15.8ml/m2 vs. 83.3±15.8ml/m2；P = 0.06;ICC 0.99 (95% CI 0.98 - -1.00)), RVEF(52.8±8.0%和51.6±7.2%;P = 0.06;ICC 0.96 [95% CI 0.89-0.99])和RVEDVI(80.8±17.6ml/m2 vs. 80.9±16.5ml/m2；P = 0.91;ICC 0.98 [95% ci 0.96-0.99])。1例患者肺部舌部突出，图像质量不符合DUS门控的诊断。结论：DUS的CMR门控是可行的，在图像质量和定量参数评估方面可以提供与ECG相当的性能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.