BACKGROUND Cardiovascular magnetic resonance (CMR) represents the clinical gold standard for the assessment of biventricular morphology and function. Since manual post-processing is time-consuming and prone to observer variability, efforts have been directed towards automated volumetric quantification. In this study, we sought to validate the accuracy of a novel approach providing fully automated quantification of biventricular volumes and function in a "real-world" clinical setting. METHODS Three-hundred CMR examinations were randomly selected from the local data base. Fully automated quantification of left ventricular (LV) mass, LV and right ventricular (RV) end-diastolic and end-systolic volumes (EDV/ESV), stroke volume (SV) and ejection fraction (EF) were performed overnight using commercially available software (suiteHEART®, Neosoft, Pewaukee, Wisconsin, USA). Parameters were compared to manual assessments (QMass®, Medis Medical Imaging Systems, Leiden, Netherlands). Sub-group analyses were further performed according to image quality, scanner field strength, the presence of implanted aortic valves and repaired Tetralogy of Fallot (ToF). RESULTS Biventricular automated segmentation was feasible in all 300 cases. Overall agreement between fully automated and manually derived LV parameters was good (LV-EF: intra-class correlation coefficient [ICC] 0.95; bias - 2.5% [SD 5.9%]), whilst RV agreement was lower (RV-EF: ICC 0.72; bias 5.8% [SD 9.6%]). Lowest agreement was observed in case of severely altered anatomy, e.g. marked RV dilation but normal LV dimensions in repaired ToF (LV parameters ICC 0.73-0.91; RV parameters ICC 0.41-0.94) and/or reduced image quality (LV parameters ICC 0.86-0.95; RV parameters ICC 0.56-0.91), which was more common on 3.0 T than on 1.5 T. CONCLUSIONS Fully automated assessments of biventricular morphology and function is robust and accurate in a clinical routine setting with good image quality and can be performed without any user interaction. However, in case of demanding anatomy (e.g. repaired ToF, severe LV hypertrophy) or reduced image quality, quality check and manual re-contouring are still required.

中文翻译：

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心血管磁共振中双心室体积和功能的全自动定量：对临床常规设置的适用性。


背景技术心血管磁共振(CMR)代表了评估双心室形态和功能的临床金标准。由于手动后处理非常耗时且易于观察者的变化，因此人们已将努力转向自动体积量化。在这项研究中，我们试图验证一种新方法的准确性，该方法可在“现实世界”的临床环境中对双心室体积和功能进行全自动量化。方法从本地数据库中随机抽取300份CMR检查。使用市售软件过夜对左心室 (LV) 质量、左心室 (LV) 质量、左心室 (RV) 舒张末期和收缩末期容积 (EDV/ESV)、每搏输出量 (SV) 和射血分数 (EF) 进行全自动定量（suiteHEART®，Neosoft，美国威斯康星州皮沃基）。将参数与手动评估进行比较（QMass®，Medis 医疗成像系统，莱顿，荷兰）。根据图像质量、扫描仪场强、植入主动脉瓣和修复法洛四联症 (ToF) 的存在，进一步进行亚组分析。结果 双心室自动分割在所有 300 例病例中都是可行的。全自动和手动得出的 LV 参数之间的总体一致性良好（LV-EF：组内相关系数 [ICC] 0.95；偏差 - 2.5% [SD 5.9%]），而 RV 一致性较低（RV-EF：ICC 0.72） ; 偏差 5.8% [SD 9.6%]）。在解剖结构严重改变的情况下观察到最低的一致性，例如明显的右心室扩张，但修复后的 ToF 中左心室尺寸正常（左心室参数 ICC 0.73-0.91；右心室参数 ICC 0.41-0.94）和/或图像质量降低（左心室参数 ICC 0.86-0.95） ; RV 参数 ICC 0.56-0.91)，这在 3.0 T 上比在 1.5 T 上更常见。 结论 双心室形态和功能的全自动评估在临床常规环境中稳健且准确，具有良好的图像质量，并且无需任何用户交互即可执行。然而，如果解剖结构要求较高（例如修复后的 ToF、严重的左室肥厚）或图像质量下降，仍然需要进行质量检查和手动重新轮廓。