心脏磁共振特征追踪技术用于评价乳腺癌患者蒽环类药物心脏毒性作用的初步研究  

The Preliminary Prediction of Anthracycline Cardiotoxicity after Chemotherapy in Patients with Breast Cancer Using Cardiac Magnetic Resonance Feature Tracking

作　　者：陈辉[1] 李昕 任睿泽 张晨[1] 方凤奇[3] 宋清伟[1] 刘爱连[1] 夏云龙[4] 李智勇[1] CHEN Hui;LI Xin;Ren Rui-ze(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116000,Liaoning Province,China)

机构地区：[1]大连医科大学附属第一医院放射科,辽宁大连116000 [2]大连医科大学附属第一医院乳腺外科,辽宁大连116000 [3]大连医科大学附属第一医院肿瘤内科,辽宁大连116000 [4]大连医科大学附属第一医院心内科,辽宁大连116000

出　　处：《中国CT和MRI杂志》2020年第9期100-103,116,共5页Chinese Journal of CT and MRI

基　　金：辽宁省教育厅科研基金项目(编号L2016021);辽宁省科技厅科研项目(编号20170540235)。

摘　　要：目的初步探讨心脏磁共振特征追踪技术用于评估蒽环类药物对左心室心脏毒性的可行性情况。方法本文纳入乳腺癌术后接受蒽环类化疗的患者11例,均为女性,年龄28~59岁。所有研究对象均在化疗前基础状态、化疗1个月及6个月时完成心脏磁共振(CardiacMagnetic Resonance,CMR)检查。应用Reportcard软件测量左心室射血分数;应用Circle Cardiovascular Imaging 42软件测量左心室径向应变、收缩期径向应变率、舒张期径向应变率、圆周应变、收缩期圆周应变率、舒张期圆周应变率、纵向应变、收缩期纵向应变率、舒张期纵向应变率。使用SPSS22统计软件分析三组之间的心功能及应变差异性情况。结果在蒽环类化疗前基础状态、化疗1个月及6个月时乳腺癌患者的LVEF均无统计学差异(P>0.05);左心室心肌应变参数RS、SRSR、DRSR、CS、DCSR与蒽环类药物化疗时间的相对延长具有负相关性(-0.41,0.02;-0.39,0.03;-0.35,0.05;-0.43,0.01;-0.37,0.04);LVEF值与蒽环类药物化疗时间的相对延长也具有负相关性(-0.39,0.03)。在化疗后6个月时,乳腺癌患者左心室DRSR呈现显著降低,差异具有统计学意义(P<0.05)。结论对乳腺癌蒽环类药物化疗后导致的早期心肌损害检测中,心脏磁共振特征追踪技术对其具有一定的帮助。Objective The feasibility of cardiac Magnetic Resonance feature tracking technology for evaluating the cardiotoxic effects of anthracyclines on the left ventricle was initially explored.Methods 11 volunteers with breast cancer (all women,28~59 years) were enrolled in this study.All of them performed CMR on 3.0T magnetic resonance at basis condition before chemotherapy,1 month after chemotherapy,6 month after chemotherapy.We measured LVEF using Reportcard software.We measured radial peak strain,peak systolic radial strain rate,peak diastolic radial strain rate,circumferential peak strain,peak systolic circumferential strain rate,peak diastolic circumferential strain rate,longitudinal peak strain,peak systolic longitudinal strain rate,peak diastolic longitudinal strain rate using Circle Cardiovascular Imaging 42 software.We analyzed the difference of cardiac function and myocardial strain between three different times.Results LVEF of patients with breast cancer among basis condition before chemotherapy,1 month after chemotherapy,6 month after chemotherapy lack of statistic difference (P>0.05).There are a certain negative correlation between RS、SRSR、DRSR、CS、DCSR and duration of chemotherapy in patients with breast cancer (-0.41,0.02;-0.39,0.03;-0.35,0.05;-0.43,0.01;-0.37,0.04).There are also a negative correlation between LVEF and duration of chemotherapy in patients with breast cancer (0.39,0.03).DRSR at 6 month after chemotherapy show significant decrease and has statistic difference (P<0.05).Conclusion In the early detection of myocardial damage caused by breast cancer anthracycline chemotherapy,cardiac magnetic resonance signature tracking technology has some help.

关 键 词：磁共振成像 特征追踪 肿瘤 化疗 形变 

分 类 号：R445.2[医药卫生—影像医学与核医学] R73[医药卫生—诊断学]