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Effect of Endocardial Trabeculae on Left Ventricular Measurements and Measurement Reproducibility at Cardiovascular MR Imaging¹

¹ From Medical Clinic I (T.P., T.S.) and Dept of Radiology (M.S., C.K.B.), Univ Hosp of Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; and Dept of Cardiology, VU Univ Medical Ctr, Amsterdam, the Netherlands (H.P.K., O.B., A.B., M.M.B.H., A.C.v.R.). Received Apr 8, 2004; revision requested Jun 18; revision received Jul 30; accepted Aug 25. T.P. supported by a grant from the Medical Faculty of the Univ of Mannheim. H.P.K. supported in part by grants from the Medical Faculty of the Rheinisch-Wesfälische Technische Hochschule, Aachen, Germany, and the Grimmke-Stiftung, Düsseldorf, Germany. O.B. supported by grant 2001.158 from the Netherlands Heart Foundation. Address correspondence to T.P. (e-mail: theano.papavassilliu{at}med.ma.uni-heidelberg.de).

View larger version (103K): [in a new window]   Figure 1a. Single short-axis-view true FISP MR images (3.2/1.2) obtained in patient with impaired LV systolic function. (a) ED (left) and ES (right) images show inclusion of trabeculae in LV cavity volume. (b) ED (left) and ES (right) images show exclusion of trabeculae from LV cavity volume. The effect of trabeculae on the drawing of endocardial border contours is evident.

View larger version (103K): [in a new window]   Figure 1b. Single short-axis-view true FISP MR images (3.2/1.2) obtained in patient with impaired LV systolic function. (a) ED (left) and ES (right) images show inclusion of trabeculae in LV cavity volume. (b) ED (left) and ES (right) images show exclusion of trabeculae from LV cavity volume. The effect of trabeculae on the drawing of endocardial border contours is evident.

View larger version (41K): [in a new window]   Figure 2a. Bland-Altman plots depict interobserver agreement regarding LV measurements obtained when trabeculae were included in (a, c, e, and g) or excluded from (b, d, f, and h) the LV cavity volume. On each plot, solid line represents mean value of the differences in measurements between the two observers, dotted lines represent ±2 SDs, and shaded areas represent confidence intervals. The mean value of the two measurements is plotted along the x-axis, and the difference (observer 1 measurement minus observer 2 measurement) is plotted along the y-axis. EDV = ED LV volume, ESV = ES LV volume. Agreement between the two independent observers was better when measurements were obtained with the trabeculae included in the cavity volume (a, c, e, and g) than when measurements were obtained with the trabeculae excluded from the cavity volume (b, d, f, and h).

View larger version (52K): [in a new window]   Figure 2b. Bland-Altman plots depict interobserver agreement regarding LV measurements obtained when trabeculae were included in (a, c, e, and g) or excluded from (b, d, f, and h) the LV cavity volume. On each plot, solid line represents mean value of the differences in measurements between the two observers, dotted lines represent ±2 SDs, and shaded areas represent confidence intervals. The mean value of the two measurements is plotted along the x-axis, and the difference (observer 1 measurement minus observer 2 measurement) is plotted along the y-axis. EDV = ED LV volume, ESV = ES LV volume. Agreement between the two independent observers was better when measurements were obtained with the trabeculae included in the cavity volume (a, c, e, and g) than when measurements were obtained with the trabeculae excluded from the cavity volume (b, d, f, and h).

View larger version (44K): [in a new window]   Figure 2c. Bland-Altman plots depict interobserver agreement regarding LV measurements obtained when trabeculae were included in (a, c, e, and g) or excluded from (b, d, f, and h) the LV cavity volume. On each plot, solid line represents mean value of the differences in measurements between the two observers, dotted lines represent ±2 SDs, and shaded areas represent confidence intervals. The mean value of the two measurements is plotted along the x-axis, and the difference (observer 1 measurement minus observer 2 measurement) is plotted along the y-axis. EDV = ED LV volume, ESV = ES LV volume. Agreement between the two independent observers was better when measurements were obtained with the trabeculae included in the cavity volume (a, c, e, and g) than when measurements were obtained with the trabeculae excluded from the cavity volume (b, d, f, and h).

View larger version (48K): [in a new window]   Figure 2d. Bland-Altman plots depict interobserver agreement regarding LV measurements obtained when trabeculae were included in (a, c, e, and g) or excluded from (b, d, f, and h) the LV cavity volume. On each plot, solid line represents mean value of the differences in measurements between the two observers, dotted lines represent ±2 SDs, and shaded areas represent confidence intervals. The mean value of the two measurements is plotted along the x-axis, and the difference (observer 1 measurement minus observer 2 measurement) is plotted along the y-axis. EDV = ED LV volume, ESV = ES LV volume. Agreement between the two independent observers was better when measurements were obtained with the trabeculae included in the cavity volume (a, c, e, and g) than when measurements were obtained with the trabeculae excluded from the cavity volume (b, d, f, and h).

View larger version (46K): [in a new window]   Figure 2e. Bland-Altman plots depict interobserver agreement regarding LV measurements obtained when trabeculae were included in (a, c, e, and g) or excluded from (b, d, f, and h) the LV cavity volume. On each plot, solid line represents mean value of the differences in measurements between the two observers, dotted lines represent ±2 SDs, and shaded areas represent confidence intervals. The mean value of the two measurements is plotted along the x-axis, and the difference (observer 1 measurement minus observer 2 measurement) is plotted along the y-axis. EDV = ED LV volume, ESV = ES LV volume. Agreement between the two independent observers was better when measurements were obtained with the trabeculae included in the cavity volume (a, c, e, and g) than when measurements were obtained with the trabeculae excluded from the cavity volume (b, d, f, and h).

View larger version (50K): [in a new window]   Figure 2f. Bland-Altman plots depict interobserver agreement regarding LV measurements obtained when trabeculae were included in (a, c, e, and g) or excluded from (b, d, f, and h) the LV cavity volume. On each plot, solid line represents mean value of the differences in measurements between the two observers, dotted lines represent ±2 SDs, and shaded areas represent confidence intervals. The mean value of the two measurements is plotted along the x-axis, and the difference (observer 1 measurement minus observer 2 measurement) is plotted along the y-axis. EDV = ED LV volume, ESV = ES LV volume. Agreement between the two independent observers was better when measurements were obtained with the trabeculae included in the cavity volume (a, c, e, and g) than when measurements were obtained with the trabeculae excluded from the cavity volume (b, d, f, and h).

View larger version (50K): [in a new window]   Figure 2g. Bland-Altman plots depict interobserver agreement regarding LV measurements obtained when trabeculae were included in (a, c, e, and g) or excluded from (b, d, f, and h) the LV cavity volume. On each plot, solid line represents mean value of the differences in measurements between the two observers, dotted lines represent ±2 SDs, and shaded areas represent confidence intervals. The mean value of the two measurements is plotted along the x-axis, and the difference (observer 1 measurement minus observer 2 measurement) is plotted along the y-axis. EDV = ED LV volume, ESV = ES LV volume. Agreement between the two independent observers was better when measurements were obtained with the trabeculae included in the cavity volume (a, c, e, and g) than when measurements were obtained with the trabeculae excluded from the cavity volume (b, d, f, and h).

View larger version (50K): [in a new window]   Figure 2h. Bland-Altman plots depict interobserver agreement regarding LV measurements obtained when trabeculae were included in (a, c, e, and g) or excluded from (b, d, f, and h) the LV cavity volume. On each plot, solid line represents mean value of the differences in measurements between the two observers, dotted lines represent ±2 SDs, and shaded areas represent confidence intervals. The mean value of the two measurements is plotted along the x-axis, and the difference (observer 1 measurement minus observer 2 measurement) is plotted along the y-axis. EDV = ED LV volume, ESV = ES LV volume. Agreement between the two independent observers was better when measurements were obtained with the trabeculae included in the cavity volume (a, c, e, and g) than when measurements were obtained with the trabeculae excluded from the cavity volume (b, d, f, and h).