[Interindividual-variability of the analysis of regional myocardial wall function after myocardial infarction and revascularization].
OBJECTIVE
The gold standard for diagnosis myocardial viability is the functional recovery after revascularization. Aim of the study was to compare (1) qualitative analysis and (2) quantitative wall thickening by cine MRI and (3) circumferential shortening by tagged MRI the analysis of regional wall function of an infarcted area before and after revascularization.


METHODS
Ten patients (age 60 +/- 11 years) with infarct-associated regional left ventricular wall motion abnormalities were examined by cine and tagged MRI on average two weeks after the myocardial infarction and re-examined three months after revascularization. Eight healthy volunteers served as a control for tagged MRI. Interobserver-variabilities of two observers were calculated using the kappa-statistics for grading of wall motion abnormalities as well as for detection of functional recovery by qualitative analysis, measurement of wall thickening of cine MRI, and measurement of circumferential shortening by tagged MRI, respectively.


RESULTS
Grading of wall motion abnormalities revealed interobserver-variabilities of the study and control group of kappa = 0.8 and kappa = 0.84, kappa = 0.02 and kappa = 0.5, and kappa = 0.1 and kappa = 0.17 for qualitative analysis, wall thickening analysis and measurement of circumferential shortening, respectively. The interobserver-variability for the definition of wall motion recovery was kappa = 0.8 for all three methods.


CONCLUSIONS
Qualitative analysis of wall motion abnormalities has the lowest interobserver-variability for the grading of wall motion abnormalities. The interobserver-variabilities of qualitative and quantitative analysis are comparable for the diagnosis of regional wall motion recovery. Thus, qualitative analysis of cine MRI can be used for grading regional wall motion in clinical studies.
Sandstede
J
J
Institut für Röntgendiagnostik der Universität Würzburg. joern.sandstede@mail.uni-wuerzburg.de
Machann
H
H
Machann
W
W
Beer
M
M
Johnson
T
T
Harre
K
K
Pabst
T
T
Kenn
W
W
Hahn
D
D
D000368:Aged; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D009204:Myocardial Revascularization; D015588:Observer Variation; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D016277:Ventricular Function, Left / Q000502:physiology