定量评价慢性心力衰竭患者心肌细胞外容积-双能量CT与心脏磁共振的对照研究  

Quantitation of extracellular volume in patients with heart failure:dual-energy CT vs cardiac magnetic resonance

作　　者：王瑞[1] 刘新民[1] 罗太阳[1] 周振 王宏伟 张朝 吴伟[1] 徐磊[1] WANG Rui;LIU Xinmin;LUO Taiyang;ZHOU Zhen;WANG Hongwei;ZHANG Chao;WU Wei;XU Lei(Department of Radiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所医学影像科,100029

出　　处：《心肺血管病杂志》2020年第7期839-842,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:以3T心脏磁共振为参考标准,探讨心脏双能量CT定量评价慢性心力衰竭患者细胞外容积(ECV)的可行性和准确性。方法:28例临床诊断心力衰竭患者前瞻性入选本研究。双能量CT延迟扫描用于计算心肌ECV,双能量CT心肌ECV(DECT-ECV)计算公式=(HU心肌/HU血池)×(1-红细胞压积)×100%。CMR心脏测量功能参数,包括LVEF,左心室舒张末期容积和收缩末期容积,每搏输出量和心输出量。DECT-ECV和CMR-ECV的比较采用秩和检验,相关性分析采用Pearson检验。所有患者均签署知情同意书。结果:DECT-ECV中位数为36%(32%~51%),CMR-ECV中位数为31%(30%~46%),两者具有很好的相关性(r=0.911,P<0.001)。DECT-ECV的结果比CMR-ECV高15.8%;DECT-ECV和CMR-ECV与射血分数呈负相关。DECT有效辐射剂量(4.1±1.1)mSv。结论:DECT-ECV能够用于定量评价心肌细胞外间隙,但是DECT-ECV可能会高估心肌细胞外间隙的程度。Objective:The aim of this study is to evaluate the feasibility and accuracy of DECT technique in determining the ECV in patients with heart failure,3T CMR as the reference.Methods:Twenty-eight patients with various reasons of heart failure were perspective enrolled in this study.ECVs were calculated,and the relationship between DECT-ECV,CMR-ECV,and other heart function parameters,including left ventricular end systolic and diastolic volume,cardiac output and ejection fraction(LVESV,LVEDV,CO,LVEF)was determined.All participants gave informed consent,and the study was approved by the institutional review board.Results:The median ECVs on DECT and CMR were 36%(32%-51%)and 31%(30%-46%),respectively.A good correlation between myocardial ECV at DECT and that at CMR(r=0.911,P<0.001)was observed.DECT ECV has overestimated 15.8%than that of CMR.Both ECVs,for DECT and CMR,were inversely associated with LVEF.Conclusions:DECT-based ECV could be an alternative non-invasive imaging tool for myocardial tissue characterization.However,overestimation of the extent of ECV is observed with use of DECT.

关 键 词：心力衰竭 心肌纤维化 细胞外间隙 计算机体层成像 磁共振成像 

分 类 号：R54[医药卫生—心血管疾病]