title: The role of still-frame parametric imaging in magnetic resonance assessment of left ventricular wall motion by non-cardiologists.
abstract: BACKGROUND
  Cardiac magnetic resonance (MR) images are often reviewed by non-cardiologists who are not trained in the interpretation of regional left ventricular (LV) function. We hypothesized that the use of still-frame parametric MR images of wall motion could aid in the assessment of regional LV function.
  
  
  METHODS
  Dynamic, electrocardiogram-gated, steady-state free precession (FIESTA) short-axis images were obtained in 6 to 10 slices in 18 consecutive patients. Each loop was used to automatically generate a still-frame image, in which each pixel is assigned a value equal to the amplitude of cyclic variation in local intensity, resulting in higher intensity in pixels that change between blood and tissue during the cardiac cycle. The dynamic images were reviewed by an expert cardiologist who provided gold standard grades for regional wall motion and by four radiologists. Then the radiologists reviewed and graded the same MR images in combination with parametric images. Grades assigned to each segment in the two sessions were compared with the gold standard.
  
  
  RESULTS
  According to expert interpretation, 6 patients had normal wall motion, and 12 had wall motion abnormalities. Parametric images showed a bright band in the area spanned by endocardial motion, with reduced brightness and thickness in areas of hypokinesis. The agreement between the radiologists' grades and the gold standard significantly improved by adding parametric images (from 77% to 81%), which also resulted in reduced interobserver variability (from 52% to 33%).
  
  
  CONCLUSIONS
  Still-frame parametric images aid in the assessment of regional wall motion by non-cardiologists who are required to interpret cardiac images.
authors.affiliation: Noninvasive Cardiac Imaging Laboratory, University of Chicago Medical Center, Chicago, Illinois 60637, USA.
authors.forename: Enrico G
authors.initials: EG
authors.lastname: Caiani
authors.forename: Eran
authors.initials: E
authors.lastname: Toledo
authors.forename: Peter
authors.initials: P
authors.lastname: MacEneaney
authors.forename: Keith A
authors.initials: KA
authors.lastname: Collins
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lang
authors.forename: Victor
authors.initials: V
authors.lastname: Mor-Avi
mesh_terms: D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011871:Radiology; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology