Objective assessment of left ventricular wall motion from cardiac magnetic resonance images

Cardiac MRI diagnosis of regional LV dysfunction relies on subjective interpretation of cine images that suffers from wide inter-observer variability, especially when performed by readers not trained in the assessment of regional wall motion. We developed a method for objective, automated detection of regional wall motion abnormalities. Cine images (GE 1.5 T, FIESTA) were obtained in 6-10 short axis slices in 10 pts. Images were reviewed by an expert cardiologist whose grades were used as the gold standard. Images were then analyzed using custom software. In each slice, endocardial border was detected semiautomatically and divided into 6 segments. Regional fractional area change (RFAC) was computed and displayed as "bull's eyes". RFAC<50% was considered abnormal. The "bull's eyes" showed dark areas in segments judged as abnormal by the expert reader. The automated detection had sensitivity 79%, specificity 78%, accuracy 78%. Analysis of endocardial motion from MRI images provides the basis for accurate, automated and objective interpretation of regional wall motion.