Visual estimation of the extent of myocardial hyperenhancement on late gadolinium-enhanced CMR in patients with hypertrophic cardiomyopathy

Abstract Aim So far different approaches have been used to quantify late gadolinium enhancement (LGE) in patients with hypertrophic cardiomyopathy (HCM), but there is no general consensus on the gold standard, since histological data are scarce. The aim of our study was to investigate whether the determination of LGE in patients with HCM using a semiquantitative score based on the 17-segment model is feasible and has comparable accuracy to manual planimetry. Methods Forty-two patients with HCM underwent LGE cardiovascular magnetic resonance imaging. Determination of LGE by planimetry based on visual assessment was used as reference standard. Then the extent of LGE was assessed using a semiquantitative score based on the standard left ventricular 17-segment model. Each segment was scored for the distribution of LGE. The resulting summed score expressed as percentage of the maximum possible score was thereafter compared with the manual planimetric evaluation of LGE, expressed as a percentage of the left ventricular myocardial area. Results In 28 patients (66%), LGE was present. There was a good correlation between the semiquantitative score and the planimetric approach ( r =0.89; y =0.819 x +2.45; standard error of estimation=2.327; P