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J Magn Reson Imaging. 2006 Mar;23(3):309-14.

Quantitative myocardial infarction on delayed enhancement MRI. Part II: Clinical application of an automated feature analysis and combined thresholding infarct sizing algorithm.

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1
Laboratory of Cardiac Energetics, National Heart Lung and Blood Institute, National Institutes of Health/DHHS, 10 Center Drive, Bethesda, MD 20892, USA.

Abstract

PURPOSE:

To compare global and regional myocardial infarction (MI) measurements on clinical gadolinium-enhanced magnetic resonance (MR) images using human manual contouring and a computer algorithm previously validated by histopathology, and to study the degree to which visual assessment and human contouring of infarct extent agreed with the computer algorithm.

MATERIALS AND METHODS:

Infarct size in 20 patients was measured by human manual contouring and with an automated feature analysis and combined thresholding (FACT) computer algorithm. Short-axis slices were divided into myocardial sectors for regional analysis. Extent of infarction was also graded visually by consensus of expert readers and compared to human and computer contouring.

RESULTS:

Despite good correlations (R = 0.93-0.95) between human contouring and the FACT algorithm, human contouring overestimated infarct size by 3.8% of the left ventricle (23.8% of the MI) area (P < 0.001). Human contouring also overestimated the circumferential extent, transmural extent, and extent of infarction within a sector by 7.1%, 18.2%, and 27.9%, respectively (all P < 0.001). Both consensus reading and human contouring overestimated infarct grades compared with the FACT algorithm (P = 0.002 and P < 0.001).

CONCLUSION:

Clinically relevant overestimation of MI can occur in visual interpretation and in human manual contouring, particularly with respect to extent of infarction on a regional basis.

PMID:
16450368
DOI:
10.1002/jmri.20495
[Indexed for MEDLINE]
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