Cardiac MRI: Standardized Right and Left Ventricular Quantification by Briefly Coaching Inexperienced Personnel

ABSTRACT

MRI quantification of the cardiac ventricles is time-consuming, especially for the right ventricle due to its complex geometry. Using a short axis MRI protocol, we tested if briefly coaching persons inexperienced in cardiac MRI provides reliable right and left ventricular quantification.

22 healthy subjects (mean age 26 ± 4.2 years) underwent short-axis breath-hold SSFP sequence cardiac MRI. Two persons inexperienced in cardiac MRI independently traced endocardial and epicardial contours of both ventricles with a predefined contour tracing protocol. Measurements were repeated after visual correction of each two most basal slices of the endocardial contours and epicardial contours in the learning curve. Five random short-axis cines were retraced for intraobserver variability. Measurements were performed blinded within 4 months. Agreement was assessed with the Bland- Altman method.

No systematic bias was observed and measurements were within acceptable limits of agreement after brief coaching. Repeat measurements following visual correction significantly improved inter-observer differences, especially for mass calculations. Maximum interobserver and intraobserver disagreement of the final protocol were respectively ≤ 8% and ≤ 5%.

Brief coaching of persons inexperienced in cardiac MRI, using the short axis MRI protocol, provides reliable volume, function and mass quantification of both ventricles.