Normal CURE and RURE values for displacement encoding with stimulated echoes (DENSE) at 1.5 Tesla MRI

Abstract

Abstract Assessment of left ventricular (LV) dyssynchrony is important for diagnosing and guiding therapy in heart failure. Displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging (MRI) quantifies myocardial dyssynchrony but lacks robust reference values. Forty healthy Caucasian volunteers (18–60 years) with no history of cardiac diseases underwent CMR at 1.5T MRI scanner using 2D spiral cine DENSE research sequence. Three short-axis slices (basal, mid-ventricular, apical) were acquired from the LV. Phase images were processed with open-source DENSEanalysis software to measure circumferential (E cc ) and radial (E rr ) strains, from which circumferential uniformity estimate (CURE) and radial uniformity estimate (RURE) were computed. Participants were categorized by sex and age into groups (18–30, 31–41, and 42–60 years). DENSE-derived strain values were also compared to those obtained using MRI feature tracking (FT). Males and females differed in average E cc (− 18 ± 4 vs. − 19 ± 5%, p  = 0.01) and E rr (44 ± 20 vs. 36 ± 22%, p  = 0.001), with no differences due to age. The apical segment of RURE was higher in males ( p  = 0.04), and age did not affect RURE. CURE showed no sex‑ or age‑related variation. The lower limit of normal was 0.80 for CURE and 0.64 for RURE. When FT was compared to DENSE, mean E cc was similar (− 20% vs. − 19%), though patient-level agreement was moderate (Intra class correlation (ICC) = 0.588, p  = 0.013); FT showed lower E rr (mean 34% vs. 42%; ICC 0.304, p  = 0.062). CURE demonstrated stable values across age and sex in healthy volunteers, supporting its use as a robust marker of LV dyssynchrony with a normal threshold of ≥ 0.80. In contrast, RURE showed greater variability, although a lower reference limit of ≥ 0.64 was established.