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A Validation of Two-Dimensional In Vivo Regional Strain Computed from Displacement Encoding with Stimulated Echoes (DENSE), in Reference to Tagged Magnetic Resonance Imaging and Studies in Repeatability

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Abstract

Fast cine displacement encoding with stimulated echoes (DENSE) has comparative advantages over tagged MRI (TMRI) including higher spatial resolution and faster post-processing. This study computed regional radial and circumferential myocardial strains with DENSE displacements and validated it in reference to TMRI, according to American Heart Association (AHA) guidelines for standardized segmentation of regions in the left ventricle (LV). This study was therefore novel in examining agreement between the modalities in 16 AHA recommended LV segments. DENSE displacements were obtained with spatiotemporal phase unwrapping and TMRI displacements obtained with a conventional tag-finding algorithm. A validation study with a rotating phantom established similar shear strain between modalities prior to in vivo studies. A novel meshfree nearest node finite element method (NNFEM) was used for rapid computation of Lagrange strain in both phantom and in vivo studies in both modalities. Also novel was conducting in vivo repeatability studies for observing recurring strain patterns in DENSE and increase confidence in it. Comprehensive regional strain agreements via Bland–Altman analysis between the modalities were obtained. Results from the phantom study showed similar radial-circumferential shear strains from the two modalities. Mean differences in regional in vivo circumferential strains were −0.01 ± 0.09 (95% limits of agreement) from comparing the modalities and −0.01 ± 0.07 from repeatability studies. Differences and means from comparison and repeatability studies were uncorrelated (p > 0.05) indicating no increases in differences with increased strain magnitudes. Bland–Altman analysis and similarities in regional strain distribution within the myocardium showed good agreements between DENSE and TMRI and show their interchangeability. NNFEM was also established as a common framework for computing strain in both modalities.

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Acknowledgments

We are thankful to Ms. Lina Reynolds and Ms. Beckah Brady for their active role in recruiting healthy subjects for our study. We also thank Siemens (Dr. Xiaodong Zhong) for the imaging software for DENSE. This study was partly funded by NIH Grant R01 HL112804.

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Authors and Affiliations

  1. Department of Surgery, School of Medicine, Washington University in St. Louis, 660 S. Euclid Ave., St Louis, MO, 63110, USA

    Julia Kar, Brian P. Cupps & Michael K. Pasque

  2. The Center for Neuroscience and Regenerative Medicine, The Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 100, Bethesda, MD, 20817, USA

    Andrew K. Knutsen

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Associate Editor Jane Grande-Allen oversaw the review of this article.

Appendix A

Appendix A

Radial-circumferential shear strain (ε rθ ) calculated using two different FEA techniques which were (left) nearest neighbor finite element method (NNFEM) and (right) Measurement Analysis (MEA). MEA involved division into six unequal tetrahedron elements in the same way a single 2D myocardial slice is segmented.

figure a
Table A1 Regional radial-circumferential shear strain (ε rθ ) values using NNFEM and MEA
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Kar, J., Knutsen, A.K., Cupps, B.P. et al. A Validation of Two-Dimensional In Vivo Regional Strain Computed from Displacement Encoding with Stimulated Echoes (DENSE), in Reference to Tagged Magnetic Resonance Imaging and Studies in Repeatability. Ann Biomed Eng 42, 541–554 (2014). https://doi.org/10.1007/s10439-013-0931-2

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