Intra- and inter-reader reproducibility of blood flow measurements on the ascending aorta and pulmonary artery using cardiac magnetic resonance

Radiol Med. 2017 Mar;122(3):179-185. doi: 10.1007/s11547-016-0706-6. Epub 2016 Nov 22.

Abstract

The aim of our study was to estimate the intra- and inter-reader reproducibility of blood flow measurements in the ascending aorta and main pulmonary artery using cardiac magnetic resonance (CMR) and a semi-automated segmentation method. The ethics committee approved this retrospective study. A total of 50 consecutive patients (35 males and 15 females; mean age±standard deviation 27±13 years) affected by congenital heart disease were reviewed. They underwent CMR for flow analysis of the ascending aorta and main pulmonary artery (1.5 T, through-plane phase-contrast sequences). Two independent readers (R1, trained radiology resident; R2, lower-trained technician student) obtained segmented images twice (>10-day interval), using a semi-automated method of segmentation. Peak velocity, forward and backward flows were obtained. Bland-Altman analysis was used and reproducibility was reported as complement to 100% of the ratio between the coefficient of repeatability and the mean. R1 intra-reader reproducibility for the aorta was 99% (peak velocity), 95% (forward flow) and 49% (backward flow); for the pulmonary artery, 99%, 91% and 90%, respectively. R2 intra-reader reproducibility was 92%, 91% and 38%; 98%, 86% and 87%, respectively. Inter-reader reproducibility for the aorta was 91%, 85% and 20%; for the pulmonary artery 96%, 75%, and 82%, respectively. Our results showed a good to excellent reproducibility of blood flow measurements of CMR together with a semiautomated method of segmentation, for all variables except the backward flow of the ascending aorta, with a limited impact of operator's training.

Keywords: Blood flow; Cardiac magnetic resonance; Heart valve; Phase-contrast sequences; Reproducibility.

MeSH terms

  • Adult
  • Aorta / diagnostic imaging
  • Aorta / physiopathology*
  • Aortic Valve / diagnostic imaging
  • Aortic Valve Insufficiency / diagnostic imaging
  • Aortic Valve Insufficiency / physiopathology
  • Blood Flow Velocity / physiology
  • Cardiac Imaging Techniques
  • Female
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Defects, Congenital / physiopathology*
  • Heart Septal Defects, Ventricular / diagnostic imaging
  • Heart Septal Defects, Ventricular / physiopathology
  • Heart Valve Diseases / diagnostic imaging
  • Heart Valve Diseases / physiopathology*
  • Humans
  • Male
  • Observer Variation
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / physiopathology*
  • Pulmonary Valve / diagnostic imaging
  • Regional Blood Flow / physiology
  • Reproducibility of Results
  • Retrospective Studies
  • Tetralogy of Fallot / diagnostic imaging
  • Tetralogy of Fallot / physiopathology
  • Truncus Arteriosus, Persistent / diagnostic imaging
  • Truncus Arteriosus, Persistent / physiopathology