Validity and Reliability of Three-chamber-View Three-directional Encoded Phase-contrast Magnetic Resonance Velocity-Vector Mapping for Transmitral Velocity Measurements: Comparison with Doppler Echocardiography and Intra- and Inter-observer Variability.
OBJECTIVE
Three-chamber view (3ch.) three-directional encoded phase-contrast magnetic resonance velocity vector mapping (PCMRVM) has been used for visualization and assessment of intra-cardiac flow. Although transmitral inflow velocity can be determined using this method by tracing mitral tips during the cardiac phase, its feasibility for clinical applications has not been established. Our aim was to investigate the validity and reproducibility of 3ch. PCMRVM for determining transmitral inflow velocity.


METHODS
We conducted 3ch. PCMRVM for 32 patients and eight healthy volunteers and analyzed the transmitral inflow pattern and early (E) and late (A) diastolic velocity. Nine patients also underwent Doppler echocardiography to evaluate correlations between the methods for E and A velocities and the E/A ratio. Intra- and inter-observer variability were calculated using intraclass correlation coefficients (ICC [1, 1] and ICC [2, 1]) for peak E and A velocities, Spearman's rank correlation coefficient for the E/A ratio, and Cohen's kappa coefficient for the inflow pattern.


RESULTS
Bland-Altman plots indicated that 3ch. PCMRVM showed systemically lower velocities than Doppler echocardiography for E (3 [25.8] 48.6) and A (-6.28 [21] 48.3); however, a strong correlation was observed (r = 0.81, P < 0.0001). The E/A ratio was not statistically different between the two modalities (P = 0.21). The intra- and inter-observer variabilities for peak E and A velocities and the E/A ratio demonstrated nearly perfect agreement or strong correlations, except for the peak E velocity (ICC [2, 1] = 0.751).


CONCLUSIONS
Based on these results, 3ch. PCMRVM can be used for both visualization and assessment of intra-cardiac flow and evaluation of the transmitral inflow velocity.
Department of Radiology, Saga University Hospital.
Munemura
M
Suzuki
Norihiko
N
Kotooka
Masashi
M
Sakuma
Takahiko
T
Nakazono
Koichi
K
Node
Hiroyuki
H
Irie
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000502:physiology* / Q000503:physiopathology; D015588:Observer Variation; D015203:Reproducibility of Results; D055815:Young Adult