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Validation of in vivo myocardial strain measurement by magnetic resonance tagging with sonomicrometry

Susan B. Yeon, MD, FACC^*, Nathaniel Reichek, MD, FACC, Barbara A. Tallant, VMD, João A. C. Lima, MD, FACC, Linda P. Calhoun, MD, FACC, Neil R. Clark, MD, FACC, Eric A. Hoffman, PhD^||, Kalon K. L. Ho, MD, MSc, FACC^* and Leon Axel, PhD, MD ^¶

^* Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Division of Cardiology, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA
Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Cardiology Division, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
^|| Department of Radiology, University of Iowa College of Medicine, Iowa City, Iowa, USA
^¶ the Devon Imaging Center and Pendergrass Laboratory, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA

View larger version (23K): [in a new window]   Figure 1 Diagram of a short-axis image of left ventricle tagged with spatial modulation of magnetization (SPAMM). (A) At sites where SPAMM stripes were perpendicular to the endocardium at end-diastole, interstripe distance was measured normal to these stripes or parallel to the endocardium. (B) At sites where adjacent stripes were oriented at 45° to the endocardial surface, the interstripe distance was measured at stripe intersections aligned parallel to the endocardium.

View larger version (130K): [in a new window]   Figure 2 End-diastolic (A) and end-systolic (B) short-axis spatial modulation of magnetization images of canine left ventricle in a basal location remote from ischemia demonstrating characteristic normal systolic stripe deformation. Note the presence of derangement in normal pattern of contraction immediately adjacent to the crystal associated artifact (arrow).

View larger version (123K): [in a new window]   Figure 3 End-diastolic (A) and end-systolic (B) spatial modulation of magnetization images of canine left ventricle in an apical location in the region of ischemia. Loss of contraction is demonstrated in a region of diastolic wall thinning (arrow) as well as in an adjacent region with normal diastolic thickness (arrowhead) by lack of normal systolic wall thickening and lack of normal stripe deformation.

View larger version (14K): [in a new window]   Figure 4 Plot of relation between percent circumferential shortening (%S) as determined by sonomicrometry and %S determined by spatial modulation of magnetization at (A) end-systole (n = 30) and (B) at late systole (n = 34). SPAMM = spatial modulation of magnetization.

View larger version (16K): [in a new window]   Figure 5 Bland-Altman plots for comparison of percent circumferential shortening (%S) comparing the ratio of spatial modulation of magnetization (SPAMM) %S and sonomicrometry (sono) %S at (A) end-systole and (B) end-diastole to average %S (0.01 was added to end-diastolic %S for this plot to avoid division by 0).