title: Precision of pulmonary vein diameter measurements assessed by CE-MRA and steady-state-free precession imaging.
abstract: OBJECTIVE
  Pulmonary vein (PV) diameter assessment is important for planning and follow-up of PV ablation in atrial fibrillation. Therefore, the aim of our study was to evaluate inter- and intraobserver reliability of PV diameter measurements by contrast-enhanced magnetic resonance angiography (CE-MRA) and ECG-gated 2D multislice unenhanced steady-state-free precession sequences (multislice SSFP).
  
  
  METHODS
  Sixty PV diameters in 17 consecutive patients were measured in transverse and coronal orientation with CE-MRA and multislice SSFP by two observers. Statistics to evaluate inter- and intraobserver reliability included Bland-Altman analysis and F-test.
  
  
  RESULTS
  Intraobserver limits of agreement (LAG) ranged between ±0.50 cm (transverse) and ±0.86 cm (coronal) for CE-MRA versus ±0.40 cm (transverse) and ±0.67 cm (coronal) for multislice SSFP. Interobserver agreement showed LAG ranging between ±0.59 cm (transverse) and ±0.83 cm (coronal) for CE-MRA versus ±0.34 cm (transverse) and ±0.75 cm (coronal) for multislice SSFP. Intra- and interobserver variances did not reveal significant differences between CE-MRA and multislice SSFP in any orientation (all p-values >0.05).
  
  
  CONCLUSIONS
  Multislice SSFP and CE-MRA enable comparable precision of PV diameter measurements. However, both methods reveal a wide range of intra- and interobserver agreement, which has to be thoroughly considered in clinical use.
  
  
  CONCLUSIONS
  • Unenhanced magnetic resonance imaging can now provide measurement of pulmonary vein diameters • Steady-state-free precession offers a new method of performing unenhanced MR imaging • Both unenhanced and enhanced MRI measurements show wide intra- and interobserver variation • PV diameter measurements assessed by MRI have to be interpreted with care • Nevertheless, unenhanced MRI might replace some CT examinations for pulmonary vein demonstration.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. groth.michael@googlemail.com
authors.forename: Michael
authors.initials: M
authors.lastname: Groth
authors.forename: Peter
authors.initials: P
authors.lastname: Bannas
authors.forename: Marc
authors.initials: M
authors.lastname: Regier
authors.forename: Jan H
authors.initials: JH
authors.lastname: Buhk
authors.forename: Kai
authors.initials: K
authors.lastname: Müllerleile
authors.forename: Gerhard
authors.initials: G
authors.lastname: Adam
authors.forename: Frank O
authors.initials: FO
authors.lastname: Henes
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000473:pathology; D015331:Cohort Studies; D003251:Constriction, Pathologic; D003287:Contrast Media / Q000494:pharmacology; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011667:Pulmonary Veins / Q000033:anatomy & histology / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media