心脏磁共振T1 Mapping技术和ECV评估扩张型心肌病心肌纤维化应用分析  

Analysis on application of cardiac magnetic resonance T1 Mapping and ECV techniques of dilated cardiomyopathy myocardial fibrosis evaluation

作　　者：李燕 黄凌波[1] 付兵[1] 杨智[1] 赵志勇[1] 王波[1] 

机构地区：[1]成都市第五人民医院放射科,成都611130

出　　处：《中国循证心血管医学杂志》2018年第2期185-189,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：四川省医学科研课题计划项目(S15013)

摘　　要：目的探究心脏磁共振T1 Mapping成像与细胞外容积(ECV)在评估扩张型心肌病(DCM)心肌纤维化中的应用。方法选取2015年11月~2017年3月于成都市第五人民医院放射科检查的63例DCM患者作为DCM,另选取52例健康者作为对照组,所有受试者均进行T1 Mapping成像与延迟钆增强扫描,比较两组左心室质量指数、左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVEDI)、每搏输出量、心率变化。根据DCM组患者是否出现延迟强化(LGE)分为LGE组与非LGE组,分别比较DCM组和对照组、LGE组和非LGE组的增强前T1值、增强后5 min、15 min、30 min的T1值、细胞外容积(ECV)值。构建受试者工作特征(ROC)曲线,分析增强前TI、ΔTI、ECV区分DCM组与对照组的曲线下面积(AUC)并比较TI、ΔTI、ECV的诊断效能。结果 DCM组左心室质量指数、LVEDV、LVEDI均高于对照组,LVEF、每博输出量均低于对照组,差异均有统计学意义(P<0.05)。两组患者心率比较差异无统计学意义(P>0.05)。DCM组增强前T1、增强后5 min、15 min、30 min T1值、ECV值均高于对照组,差异有统计学意义(P<0.05)。DCM组中LGE组43例,非LGE组19例,LGE组增强前T1、增强后5 min T、15 min、30 min T1、ECV均高于非LGE组,差异有统计学意义(P<0.05)。ROC曲线区分DCM组和对照组,ECV的AUC值高于ΔTI和增强前T1。增强前TI、ΔTI、ECV区分两组的敏感度、准确率对比,差异有统计学意义(P<0.05)。ECV敏感度、准确率高于增强前T1,差异有统计学意义(P<0.05),ΔTI和ECV敏感度、准确率对比,差异无统计学意义(P>0.05)。结论心脏磁共振T1Mapping和ECV技术在评估均DCM心肌纤维化中具有较高的应用价值。Objective To explore the application of cardiac magnetic resonance T1 Mapping and ECV techniques of dilated cardiomyopathy myocardial （DCM） fibrosis evaluation. Methods 63 patients with DCM were selected as DCM group, and 52 healthy subjects were selected as the control group. All the subjects were given T1Mapping imaging and delayed gadolinium enhanced scan. Left ventricular ejection fraction （LVEF）, left ventricular end diastolic volume （LVEDV）, left ventricular end systolic volume （LVEDI）, and stroke volume were compared between the two groups. According to appearance of delayed enhancement （LGE）, subjects were divided into LGE group and non-LGE group. T1 value before enhancement, T1 and ECV value at 5min, 15min, 30min after enhancement were compared, and the receivers operating characteristic curve （ROC） was constructed to calculate area under curve （AUC） of TI before enhancement, ΔTI, ECV, and TI. Diagnostic efficacy of ΔTI, ECV were compared. Results Left ventricular mass index, LVEDV and LVEDI in DCM group were higher than those in the control group, and LVEF and stroke volume were lower than those in the control group, with statistically significant difference （P〈0.05）. There was no significant difference in heart rate between the two groups （P〉0.05）. T1 value before enhancement, T1 and ECV value at 5min, 15min, 30min after enhancement in DCM group were higher than those in the control group, with statistically significant difference （P〈0.05）. In DCM group, there were 43 cases of LGE and 19 cases of non-LGE. T1 value before enhancement, T1 and ECV value at 5min, 15min, 30min after enhancement in LGE group were all higher than those in non-LGE group, with statistically significant difference （P〈0.05）. AUC value of ECV was higher than that of ΔTI and T1 before enhancement. There was statistically significant difference in sensitivity and accuracy of T1 before enhancement, ΔTI, ECV （P〈0.05）. The sensitivity and accuracy of ECV were higher than

关 键 词：心脏磁共振 T1Mapping 细胞外容积 扩张型心肌病 心肌纤维化 

分 类 号：R542.2[医药卫生—心血管疾病]