健康志愿者心肌T1与T2评估中感兴趣区定义及图像来源对重测可重复性的影响
两名心血管放射科医生分别基于源图像和在线图进行两次独立阅读，采用室间隔和全切片测量并施加不同侵蚀深度。结果显示室间隔ROI可重复性最差，全切片策略（T1排除心尖层面源图像分析、T2全切片在线图）精度更高，后处理选择显著影响心肌T1和T2的可重复性。
要点
- 室间隔ROI的重测和跨读者可重复性低于全切片策略。
- T1最优精度为全切片源图像分析排除心尖层面（SDD 36.6 ms，ICC 0.837）。
- T2全切片在线图重测ICC 0.903-0.915，跨读者ICC 0.901-0.910。
诊断标准与关键数值
- 平均基线T1为1001 ms（CoV 1.5%），T2为48 ms（CoV 4.4%）。
- 室间隔ROI重测ICC：T1 0.625-0.654，T2 0.438-0.653；跨读者ICC：T1 0.401-0.553，T2 0.188-0.221；SDD最高达T1 57.5 ms（5.9%）、T2 3.84 ms（9.0%）。
- T1最优精度：全切片源图像分析排除心尖层面，SDD 36.6 ms（3.7%），ICC 0.837。
- T2全切片在线图重测ICC 0.903-0.915，跨读者ICC 0.901-0.910；侵蚀从0%增至40%使SDD从1.9 ms降至1.6 ms。
临床应用与阅片要点
- 日常阅片和报告心肌T1、T2定量时，优先考虑全切片策略而非仅室间隔ROI。
- 纵向随访或跨读者比较时，注意室间隔ROI可重复性较低。
- T1分析可考虑全切片源图像并排除心尖层面以提高精度。
- T2分析可优先使用全切片在线图，并适当增加轮廓侵蚀深度。
局限性
- 研究仅纳入健康志愿者，结果可能不直接适用于患者。
- 仅评估1.5T MRI和特定序列（MOLLI、T2-prepared bSSFP）。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
RATIONALE AND OBJECTIVES: Native T1- and T2-mapping provide quantitative myocardial tissue biomarkers. For diffuse myocardial disease, mid-ventricular septal region of interest (ROI) is recommended, but evidence comparing this approach with full-slice strategies, contour erosion, and source-image fitting remains limited.
MATERIALS AND METHODS: Twenty healthy volunteers underwent two separate 1.5 T magnetic resonance imaging (MRI) examinations on the same day. Native T1 MOLLI 5(3)3 and T2-prepared balanced steady state free precession (bSSFP) mapping were acquired in three short-axis (SAx) slices (basal, mid, apical). Two cardiovascular radiologists performed two independent reading sessions, using both source images and inline maps. Septal and full-slice measurements were obtained, with increasing contour erosion depths applied. Intra-reader, inter-reader, test-retest, and cross-reader test-retest agreement was assessed using intraclass correlation coefficient (ICC)(2,1). Mixed-effects models estimated baseline values, session and reader biases, and smallest detectable differences (SDDs).
RESULTS: Mean baseline T1 was 1001 ms (CoV 1.5%) and T2 48 ms (CoV 4.4%). Septal ROI showed poorest reproducibility: test-retest ICCs 0.625-0.654 (T1) and 0.438-0.653 (T2); cross-reader ICCs 0.401-0.553 (T1) and 0.188-0.221 (T2); SDDs reached up to 57.5 ms (5.9%) for T1 and 3.84 ms (9.0%) for T2. Optimal T1 precision occurred with full-slice source-image analysis excluding apical slice (SDD 36.6 ms, 3.7%; ICC 0.837). For T2, full-slice inline maps achieved highest test-retest (0.903-0.915) and cross-reader ICCs (0.901-0.910); increasing erosion from 0% to 40% reduced SDD from 1.9 ms to 1.6 ms.
CONCLUSION: Post-processing choices materially impact myocardial T1 and T2 repeatability in healthy volunteers. Septal ROI sampling is less reproducible than full-slice strategies for longitudinal and cross-reader use.
引用
- Gherca S, Cusin A, Vallée JP, et al. Influence of Region-Of-Interest Definition and Image Source on Test-Retest Repeatability of Myocardial T1 and T2 Assessment in Healthy Volunteers. Acad Radiol. 2026. PMID: 42167982. doi:10.1016/j.acra.2026.04.052
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。