title: Intra- and inter-reader reproducibility of blood flow measurements on the ascending aorta and pulmonary artery using cardiac magnetic resonance.
abstract: The aim of our study was to estimate the intra- and inter-reader reproducibility of blood flow measurements in the ascending aorta and main pulmonary artery using cardiac magnetic resonance (CMR) and a semi-automated segmentation method. The ethics committee approved this retrospective study. A total of 50 consecutive patients (35 males and 15 females; mean age±standard deviation 27±13 years) affected by congenital heart disease were reviewed. They underwent CMR for flow analysis of the ascending aorta and main pulmonary artery (1.5 T, through-plane phase-contrast sequences). Two independent readers (R1, trained radiology resident; R2, lower-trained technician student) obtained segmented images twice (>10-day interval), using a semi-automated method of segmentation. Peak velocity, forward and backward flows were obtained. Bland-Altman analysis was used and reproducibility was reported as complement to 100% of the ratio between the coefficient of repeatability and the mean. R1 intra-reader reproducibility for the aorta was 99% (peak velocity), 95% (forward flow) and 49% (backward flow); for the pulmonary artery, 99%, 91% and 90%, respectively. R2 intra-reader reproducibility was 92%, 91% and 38%; 98%, 86% and 87%, respectively. Inter-reader reproducibility for the aorta was 91%, 85% and 20%; for the pulmonary artery 96%, 75%, and 82%, respectively. Our results showed a good to excellent reproducibility of blood flow measurements of CMR together with a semiautomated method of segmentation, for all variables except the backward flow of the ascending aorta, with a limited impact of operator's training.
authors.affiliation: Radiology Unit, Research Hospital Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Leo
authors.affiliation: Postgraduation School in Radiodiagnostic, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
authors.forename: Ida Daniela
authors.initials: ID
authors.lastname: D'Angelo
authors.affiliation: PhD Course in Integrative Biomedical Research, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. marco.ali90@gmail.com.
authors.forename: Marco
authors.identifier: http://orcid.org/0000-0001-8156-7743
authors.initials: M
authors.lastname: Alì
authors.affiliation: Radiology Unit, Research Hospital Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.
authors.forename: Paola Maria
authors.initials: PM
authors.lastname: Cannaò
authors.affiliation: Radiology Unit, Research Hospital Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mauri
authors.affiliation: Radiology Unit, Research Hospital Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Secchi
authors.affiliation: Radiology Unit, Research Hospital Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.|Department of Biomedical Science for Health, Università degli Studi di Milano, Via Morandi 30, 20097, San Donato Milanese, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sardanelli
mesh_terms: D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001021:Aortic Valve / Q000000981:diagnostic imaging; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D057791:Cardiac Imaging Techniques; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015588:Observer Variation; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011664:Pulmonary Valve / Q000000981:diagnostic imaging; D012039:Regional Blood Flow / Q000502:physiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000503:physiopathology; D014339:Truncus Arteriosus, Persistent / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Blood flow; Cardiac magnetic resonance; Heart valve; Phase-contrast sequences; Reproducibility