MR心肌应变在暴发性心肌炎初步应用及与心肌水肿相关性分析  

Value of MR myocardial strain analysis in fulminant myocarditis

作　　者：李浩杰 朱慧 杨朝霞 夏黎明[1] LI Hao-jie;ZHU Hui;YANG Zhao-xia;XIA Li-ming(Department of Radiology,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Hubei 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院放射科

出　　处：《影像诊断与介入放射学》2020年第1期48-53,共6页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金(81873889)

摘　　要：目的评估心脏磁共振(CMR)心肌应变对暴发性心肌炎诊断价值及与心肌水肿相关性。方法回顾性分析29例暴发性心肌炎患者及19例正常志愿者临床及影像学资料,均在3.0 T行CMR成像,扫描序列包括心脏电影、T2WI、T1mapping、T2mapping、延迟强化。在常规电影图像上进行心肌应变分析,得出长轴(LS)、圆周(CS)及径向(RS)应变值。两组之间采用独立样本t检验或Mann-Whitney U检验进行统计分析,心肌应变与心肌水肿进行Spearman相关性分析,并采用ROC分析各参数鉴别两者的效能。结果与对照组相比,暴发性心肌炎RS、CS、LS均明显减低,而T1、T2及细胞外容积(ECV)值明显升高。CS与T1、ECV及T2呈明显正相关性(T1:r=0.415,P<0.05;ECV:r=0.724,P<0.001;T2:r=0.469,P<0.05),RS与ECV之间存在明显负相关(r=-0.497,P<0.05)。心肌应变诊断暴发性心肌炎AUC值均较高。结论CMR心肌应变在暴发性心肌炎具有较高的诊断价值,CS及RS与心肌水肿有明显相关性。Objective To evaluate the value of magnetic resonance(MR)myocardial strain analysis in patients with fulminant myocarditis and its correlation with myocardial edema.Methods The 3T cardiac MR data of 29 patients with fulminant myocarditis and 19 healthy volunteers were analyzed retrospectively.The MR sequences included cine,black blood T2-weighted imaging,T1 mapping,T2 mapping,and late gadolinium enhancement.Myocardial strain analysis including CS,RS and LS parameters was applied on standard cine images.Independent sample t test or Mann-Whitney U test was used to compare the parameters between the two groups.Correlation analysis was performed using Spearman’s rank correlation coefficient and receiver operating characteristic(ROC)curve was used to analyze the diagnostic effectiveness of strain parameters in distinguishing the two groups.Results The patients with fulminant myocarditis demonstrated significantly reduced RS,CS and LS values compared to the healthy subjects.There were significant positive correlations between CS and T1(r=0.415,P<0.05),ECV(r=0.724,P<0.001)and T2(r=0.469,P<0.05).RS showed the strongest negative correlation with ECV(r=-0.497,P<0.05).Area under the ROC curve was higher in the diagnosis of fulminant myocarditis by myocardial strain.Conclusion MR myocardial strain analysis is valuable in fulminant myocarditis with close correlation of CS and RS with myocardial edema.

关 键 词：心脏磁共振 心肌炎 应变 功能成像 

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]