Intra- and inter-reader reproducibility of blood flow measurements on the ascending aorta and pulmonary artery using cardiac magnetic resonance

• Published in: Radiologia medica 2017-03, Vol.122 (3), p.179-185
• Main Authors: Di Leo, Giovanni, D’Angelo, Ida Daniela, Alì, Marco, Cannaò, Paola Maria, Mauri, Giovanni, Secchi, Francesco, Sardanelli, Francesco
• Format: Article
• Language: English
• Subjects: Adult; Aorta; Aorta - diagnostic imaging; Aorta - physiopathology; Aortic Valve - diagnostic imaging; Aortic Valve Insufficiency - diagnostic imaging; Aortic Valve Insufficiency - physiopathology; Blood Flow Velocity - physiology; Cardiac Imaging Techniques; Cardiac Radiology; Diagnostic Radiology; Female; Heart Defects, Congenital - diagnostic imaging; Heart Defects, Congenital - physiopathology; Heart Septal Defects, Ventricular - diagnostic imaging; Heart Septal Defects, Ventricular - physiopathology; Heart Valve Diseases - diagnostic imaging; Heart Valve Diseases - physiopathology; Humans; Imaging; Interventional Radiology; Male; Medicine; Medicine & Public Health; Neuroradiology; Observer Variation; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - physiopathology; Pulmonary Valve - diagnostic imaging; Radiology; Regional Blood Flow - physiology; Reproducibility; Reproducibility of Results; Retrospective Studies; Tetralogy of Fallot - diagnostic imaging; Tetralogy of Fallot - physiopathology; Truncus Arteriosus, Persistent - diagnostic imaging; Truncus Arteriosus, Persistent - physiopathology; Ultrasound
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-016-0706-6

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.