心脏磁共振特征追踪技术对慢性肾衰竭患者左室心肌功能的评估作用研究  

Evaluation of left ventricular myocardial function in patients with chronic renal failure by cardiac magnetic resonance feature tracking technique

作　　者：杨道玲[1] 殷洁[2] 陈静婉[1] 吴玉莲 Yang Daoling;Yin Jie;Chen Jingwan;Wu Yulian(Department of Ultrasound Medicine,Jinhua Central Hospital,Zhejiang Jinhua 321000,China;Department of Medical Imaging,Jinhua Central Hospital,Zhejiang Jinhua 321000,China)

机构地区：[1]浙江省金华市中心医院超声医学科,321000 [2]浙江省金华市中心医院医学影像科,321000

出　　处：《中国医师进修杂志》2021年第1期16-20,共5页Chinese Journal of Postgraduates of Medicine

基　　金：浙江省基础公益研究计划项目(LGF1800011);浙江省金华市科技局项目(2019-4-011)。

摘　　要：目的:探讨心脏磁共振特征追踪技术对慢性肾衰竭患者左室心肌功能的评估作用。方法:选择2018年6月至2019年6月在浙江省金华市中心医院就诊的慢性肾衰竭患者30例(慢性肾衰竭组)和同期健康体检的成人志愿者30例(健康对照组),使用Philips Acheva 3.0 T心脏磁共振成像设备,行心脏磁共振扫描,获得心脏电影序列;采用CVI42软件中的组织追踪工具对研究对象的心肌应变进行分析,检测两组左室射血分数(LVEF)、舒张末期心室容积(EDV)、收缩末期心室容积(ESV)、搏出量(AV)、整体纵向应变(GL)、整体圆周应变(GC)、整体径向应变(GR)水平,并进行比较。结果:慢性肾衰竭组EDV水平高于健康对照组[(132.3±18.5)ml比(111.5±15.1)ml],LVEF水平低于健康对照组[(62.41±2.10)%比(67.30±3.92)%],差异有统计学意义(P<0.01)。慢性肾衰竭组GL、GC、GR低于健康对照组[(-16.3±3.1)%比(-11.1±4.1)%、(-17.5±2.9)%比(-13.7±4.7)%、(36.5±9.5)%比(46.3±8.4)%],差异有统计学意义(P<0.01)。当b=300、500、800 s/mm 2,健康对照组、慢性肾衰竭组不同临床分期表观扩散系数值比较,差异有统计学意义(P<0.01)。随着慢性肾衰竭患者临床分期越高,其ADC值越来越低。结论:心脏磁共振特征追踪技术能准确、有效地评估慢性肾衰竭患者左室心肌功能指标变化。Objective To study the evaluation of left ventricular myocardial function in patients with chronic renal failure by cardiac magnetic resonance feature tracking technique.Methods Thirty patients with chronic renal failure(chronic renal failure group)who were treated in Jinhua Central Hospital of Zhejiang Province from June 2018 to June 2019 and 30 adult volunteers(healthy control group)who were examined at the same period were enrolled.The cardiac movie sequence was obtained by using Phillips Acheva 3.0 T CMR imaging equipment.The tissue tracking tool in CVI42 software was used to analyze the myocardial strain of the subjects,and the levels of left ventricular ejection fraction(LVEF),end diastolic volume(EDV),end systolic volume(ESV),apoptotic volume(AV),global longitudinal strain(GL),global circumferential strain(GC)and global radial strain(GR)were detected and compared between two groups.Results The level of EDV in chronic renal failure group was higher than that in healthy control group:(132.3±18.5)ml vs.(111.5±15.1)ml,the level of LVEF in chronic renal failure group was lower than that in healthy control group:(62.41±2.10)%vs.(67.30±3.92)%,and the differences were statistically significant(P<0.01).The levels of GL,GC and GR in chronic renal failure group were lower than those in healthy control group:(-16.3±3.1)%vs.(-11.1±4.1)%,(-17.5±2.9)%vs.(-13.7±4.7)%and(36.5±9.5)%vs.(46.3±8.4)%,and the differences were statistically significant(P<0.01).When b=300,500 and 800 s/mm2,the apparent diffusion coefficient(ADC)value of different clinical stages in healthy control group and chronic renal failure group were compared,and the differences were statistically significant(P<0.01).When the clinical stage of chronic renal failure was higher,its ADC value was lower gradually.Conclusions Cardiac magnetic resonance feature tracking technology can accurately and effectively evaluate the changes of left ventricular myocardial function in patients with chronic renal failure.

关 键 词：肾衰竭 慢性 心肌功能 心脏磁共振特征追踪技术 心脏磁共振 

分 类 号：R692.5[医药卫生—泌尿科学] R445.2[医药卫生—外科学]