title: Evaluation of Left Ventricular Outflow Tract Obstruction With Four-Dimensional Phase Contrast Magnetic Resonance Imaging in Patients with Hypertrophic Cardiomyopathy-A Pilot Study.
abstract: OBJECTIVE
  This study aimed to validate 4-dimensional phase contrast (4D PC) cine magnetic resonance imaging (MRI) as a means of evaluating left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic cardiomyopathy (HCM).
  
  
  METHODS
  In this institutional review board-approved prospective study, 23 patients with suspected HCM from October 2012 to September 2013 underwent 4D PC MRI. Postprocessed 4D PC pathline cine data were reviewed by 2 blinded reviewers to determine presence or absence of LVOT obstruction. Sensitivity, specificity, and accuracy in 4D PC qualitative and quantitative assessment of LVOT obstruction were calculated using echo as reference standard.
  
  
  RESULTS
  Consensus interpretation of 4D PC showed 100.0% (7/7) sensitivity, 75.0% specificity (12/16), and 82.6% (19/23) accuracy in assessment of LVOT obstruction. The 4D PC quantitative estimates of LVOT gradient have 71.4% (5/7) sensitivity, 93.8% (15/16) specificity, and 87.0% (20/23) accuracy in evaluation of LVOT obstruction compared with echo.
  
  
  CONCLUSIONS
  The 4D PC MRI can assess for LVOT obstruction in HCM patients.
authors.affiliation: From the *Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD; †Imaging and Computer Vision, Siemens Corporation, Corporate Technology, Princeton, NJ; ‡Department of Radiology, Stritch School of Medicine, Loyola University; ‡Feinberg School of Medicine, Northwestern University, Chicago, IL; ∥Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore; and ¶Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Chu
authors.forename: Kristin K
authors.initials: KK
authors.lastname: Porter
authors.forename: Celia Pamela
authors.initials: CP
authors.lastname: Corona-Villalobos
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Gülsün
authors.forename: Steven M
authors.initials: SM
authors.lastname: Shea
authors.forename: Michael
authors.initials: M
authors.lastname: Markl
authors.forename: Theodore P
authors.initials: TP
authors.lastname: Abraham
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Ihab R
authors.initials: IR
authors.lastname: Kamel
authors.forename: Stefan L
authors.initials: SL
authors.lastname: Zimmerman
mesh_terms: D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D003287:Contrast Media