背景:缺乏来自大型队列的人群分层心血管磁共振(CMR)参考范围是临床护理的主要缺点。
目的:本文提供了年龄-,sex-,以及健康心脏协会针对心房和心室指标的种族特定CMR参考范围,一项国际合作,包括来自经过验证的健康个体的9,088项CMR研究,涵盖两性的完整成人年龄范围,以及迄今为止报告的最高种族多样性。
方法:使用具有批处理能力的认证软件(cvi42,版本5.14原型,心血管成像圈)由2位专家读者。三种分割方法(平滑,乳头状,解剖)用于根据长轴和短轴电影系列确定心室和心房的心内膜和心外膜边界的轮廓。提取临床建立的心室和心房指标,并按年龄分层,性别,和种族。按分割方法划分的变化,扫描仪供应商,和磁体强度进行了检查。参考范围报告为95%预测间隔。
结果:样本包括4,452名(49.0%)男性和4,636名(51.0%)女性,平均年龄为61.1±12.9岁(范围:18-83岁)。其中,7,424(81.7%)来自怀特,510(5.6%)南亚,478(5.3%)混合/其他,341(3.7%)黑色,和335个(3.7%)中国族裔。使用1.5-T(n=8,779;96.6%)和3.0-T(n=309;3.4%)扫描仪从西门子(n=8,299;91.3%)获取图像,飞利浦(n=498;5.5%),和GE(n=291,3.2%)。
结论:这项工作代表了具有健康的CMR衍生体积参考范围的资源,可用于临床实施。
BACKGROUND: The absence of population-stratified cardiovascular magnetic resonance (CMR) reference ranges from large cohorts is a major shortcoming for clinical care.
OBJECTIVE: This paper provides age-, sex-, and ethnicity-specific CMR reference ranges for atrial and ventricular metrics from the Healthy Hearts Consortium, an international collaborative comprising 9,088 CMR studies from verified healthy individuals, covering the complete adult age spectrum across both sexes, and with the highest ethnic diversity reported to date.
METHODS: CMR studies were analyzed using certified software with batch processing capability (cvi42, version 5.14 prototype, Circle Cardiovascular Imaging) by 2 expert readers. Three segmentation methods (smooth, papillary, anatomic) were used to contour the endocardial and epicardial borders of the ventricles and atria from long- and short-axis cine series. Clinically established ventricular and atrial metrics were extracted and stratified by age, sex, and ethnicity. Variations by segmentation method, scanner vendor, and magnet strength were examined. Reference ranges are reported as 95% prediction intervals.
RESULTS: The sample included 4,452 (49.0%) men and 4,636 (51.0%) women with average age of 61.1 ± 12.9 years (range: 18-83 years). Among these, 7,424 (81.7%) were from White, 510 (5.6%) South Asian, 478 (5.3%) mixed/other, 341 (3.7%) Black, and 335 (3.7%) Chinese ethnicities. Images were acquired using 1.5-T (n = 8,779; 96.6%) and 3.0-T (n = 309; 3.4%) scanners from Siemens (n = 8,299; 91.3%), Philips (n = 498; 5.5%), and GE (n = 291, 3.2%).
CONCLUSIONS: This work represents a resource with healthy CMR-derived volumetric reference ranges ready for clinical implementation.