T1 mapping技术评价急性心肌梗死的动物实验研究  

Animal experimental study on evaluation of acute myocardial infarction by T1 mapping

作　　者：李霞 潘存雪 刘文亚 李媛媛 LI Xia;PAN Cunxue;LIU Wenya;LI Yuanyuan(Imaging Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院影像中心,新疆乌鲁木齐830054

出　　处：《实用放射学杂志》2020年第6期980-983,1003,共5页Journal of Practical Radiology

基　　金：新疆维吾尔自治区自然科学基金青年基金项目(2017D01C352)。

摘　　要：目的分析T1 mapping技术对急性心肌梗死(AMI)的诊断价值及参考值范围。方法选用5只家猪作为AMI模型,开胸直视下将左前降支远段结扎,制备AMI模型。造模后1 d行1.5T心脏磁共振(CMR)扫描,扫描序列包括对比剂注射前、后T1 mapping和钆对比剂延迟增强(LGE)。CMR检查结束立即处死模型,并切取左心室短轴位8 mm薄层切片并HE染色。对照病理图像,分析T1 mapping诊断AMI的效能。结果(1)以病理结果为金标准,LGE及对比剂注射前、后T1 mapping主观评价AMI的灵敏度、特异度及约登指数分别是:LGE,93.33%、94.03%、0.873;对比剂注射前T1 mapping,73.33%、88.06%、0.613;对比剂注射后T1 mapping,86.66%、97.01%、0.837。(2)以病理结果为金标准,正常心肌与梗死心肌T1值在对比剂注射前、后差异均有统计学意义;正常心肌与梗死心肌细胞外间质容积分数(ECV)值差异有统计学意义(P均<0.05)。(3)ROC曲线分析:对比剂注射前心肌T1值诊断AMI的AUC、诊断界值及95%置信区间(95%CI)分别是0.916,1065.9 ms,0.811~1;对比剂注射后是0.956,604.35 ms,0.891~1;ECV值是0.923,0.41,0.824~1。结论T1 mapping技术主观评价及客观值测量均能够较好地评价AMI,对比剂注射前、后T1值及ECV值可用于梗死及非梗死心肌的鉴别诊断。Objective To investigate the diagnostic value and reference range of the acute myocardial infarction(AMI)using T1 mapping technique.Methods Five pigs were selected as AMI model,and the distal left anterior descending branch was ligated to make AMI model.One day after modeling,1.5T CMR scanning was carried,and the scanning sequence included late gadolinium enhancement(LGE)and T1 mapping before and after contrast inj ection.At the end of CMR,the model was killed immediately,and the short axial 8 mm sections of the left ventricle were taken and stained with HE.Compared with pathological images,T1 mapping diagnosis of the efficiency of AMI was analyzed.Results(1)According to the pathological results as the gold standard,the sensitivity,specificity and Youden index of LGE and T1 mapping before and after contrast medium inj ection were as follows:LGE,93.33%,94.03%,0.873;pre-T1 mapping,73.33%,88.06%,0.613;post-T1 mapping,86.66%,97.01%,0.837,respectively.(2)According to the pathological results as the gold standard,there was significant difference on T1 value between normal myocardium and infarction myocardium before and after contrast medium inj ection,and there was significant difference in ECV value between normal myocardium and infarction myocardium(P<0.05).(3)ROC curve analysis:the AUC,the diagnostic boundary value and 95%CI of T1 value before contrast medium inj ection were 0.916,1065.9 ms and 0.811-1,respectively.After contras medium inj ection were 0.956,604.35 ms,0.891-1,ECV were 0.923,0.41,0.824-1.Conclusion AMI can be nicely evaluated through subj ective evaluation and obj ective measurement value of the T1 mapping technique,and T1 value and ECV value compared with the before and after inj ection can be used to diagnose the infarction and non-infarction myocardium.

关 键 词：动物模型 急性心肌梗死 心脏磁共振 T1 mapping 

分 类 号：R-332[医药卫生] R542.22