心肌炎CMRI左心室功能参数分析及与LGE相关性研究  

Analysis of left ventricular function parameters with CMRI in patients with myocarditis and its correlation with LGE

作　　者：袁尉峰 赵新湘[2] YUAN Wei-feng;ZHAO Xin-Xiang(Department of Radiology,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院放射科,成都610500 [2]昆明医科大学第二附属医院放射科,昆明650101

出　　处：《放射学实践》2018年第11期1137-1142,共6页Radiologic Practice

基　　金：云南省科技计划项目(2017FE468-178);云南省医学学科带头人培养计划项目(D-201646);云南省中青年学术技术带头人培养项目(2015HB068);成都医学院校基金科研项目(CYZ17-34)

摘　　要：目的:通过心肌炎患者心脏磁共振成像(CMRI)左心室功能参数分析及与晚期钆增强(LGE)的相关性研究,探讨心肌炎左心室功能与心肌间质纤维化的关系。方法:将41例心肌炎组分为L0组(LGE阴性,15例)和L组(LGE阳性,26例),L组分为La组(LGE阳性节段数<3)和Lb组(LGE阳性节段数≥3)。采用单因素方差分析和LSD-t检验比较L0组、La组、Lb组之间的左心室功能参数(LVEF、FS、LVEDD、LVEDV、LVESV、LVMM、LVSV、CO、CI);对心肌炎L组LVEF与其它左心室功能参数行Pearson直线相关分析,LVEF与LGE阳性节段数行Spearman等级相关分析。结果:心肌炎L0组、La组、Lb组间LVEF(P<0.001)、LVEDV(P=0.001)、LVESV(P<0.001)、LVSV(P<0.001)、CI(P=0.036)差异有统计学意义,余参数差异无统计学意义。心肌炎L组LVEF分别与LVEDV(P=0.032)、LVESV(P<0.001)呈负相关,与LVSV(P<0.001)、CI(P=0.012)呈正相关,与余参数不存在相关性,与LGE阳性节段数(P<0.001)呈负相关。结论:LVEF、LVEDV、LVESV、LVSV、CI能够较好地反映心肌间质的纤维化,LVEF分别与LVEDV、LVESV、LVSV、CI具有相关性。LGE有助于预测心肌炎患者左心室功能不全的发生。Objective:To analyze the left ventricular function parameters of cardiac MRI(CMRI)in patients with myocarditis and to correlate with LGE,in order to investigate the relationship of left ventricular function and myocardial interstitial fibrosis.Methods:Forty-one patients with myocarditis were divided into two groups as Group L0(LGE negative,15 patients)and Group L(LGE positive,26 patients).Furthermore,Group L was divided into Group La(LGE positive segments<3)and Group Lb(LGE positive segment≥3).Using single factor analysis of variance and LSD-t test to compare the left ventricular function parameters(LVEF、FS、LVEDD、LVEDV、LVESV、LVMM、LVSV、CO、CI)between Group L0 and Group La,Group L0 and Group Lb,Group La and Group Lb.Pearson linear correlation analysis was performed between LVEF and the other left ventricular function parameters in Myocarditis Group L,as well as LVEF and LGE positive segments were analyzed by Spearman rank correlation.Results:Significant statistic difference of LVEF was existed between Group L0,Group La and Group Lb(P<0.001),as well as LVEDV(P=0.001),LVESV(P<0.001),LVSV(P<0.001)and CI(P=0.036<0.05);no significant difference was existed in the other parameters.In Group L,LVEF was negatively correlated with LVEDV(P=0.032)and LVESV(P<0.001),and positively correlated with LVSV(P<0.001)and CI(P=0.012<0.05);no relation with the other parameters,and negatively correlated with the number of LGE positive segments(P<0.001).Conclusion:Myocardial interstitial fibrosis could be reflected by parameters including LVEF,LVEDV,LVESV,LVSV and CI.LVEF correlated respectively with LVEDV,LVESV,LVSV and CI.LGE is helpful to predict the occurrence of left ventricular dysfunction in patients with myocarditis.

关 键 词：磁共振成像 心肌炎 心室功能 心肌纤维化 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.21[医药卫生—诊断学]