磁共振T 1-mapping及细胞外容积在肥厚型心肌病中的应用价值  

Application of magnetic resonance T_(1)-mapping and extracellular volume in hypertrophic cardiomyopathy

作　　者：林青 王佳佳 葛英辉 LIN Qing;WANG Jia-jia;GE Ying-hui(Department of Radiology,Central China Fuwai Hospital,Zhengzhou 450000,China)

机构地区：[1]阜外华中心血管病医院放射科,郑州450000

出　　处：《放射学实践》2021年第9期1095-1100,共6页Radiologic Practice

基　　金：河南省医学科技攻关计划省部共建项目(2018020449);河南省医学科技攻关计划联合共建项目(SB201901097)。

摘　　要：目的:分析肥厚型心肌病(HCM)患者心肌节段纵向弛豫时间定量成像(T 1-mapping)及细胞外容积(ECV)的特点,探讨T 1-mapping及ECV对HCM的应用价值。方法:前瞻性搜集行3.0T心脏MRI检查的HCM患者56例(HCM组)及30例健康志愿者(正常对照组)。测量两组舒张末期最大左心室壁厚度、心肌质量、16个心肌节段初始和增强后T 1-mapping值,计算其ECV值,分别比较HCM组与正常对照组及HCM各亚组间相关参数的差异。结果:HCM组56例患者共有896个节段,将其分为肥厚并强化节段260个(A组)、肥厚未强化节段145个(B组)、非肥厚并强化节段15个(C组)、非肥厚未强化节段476个(D组)。HCM组舒张末期最大左心室壁厚度、心肌质量、初始T 1-mapping值均高于正常对照组[两组分别为(21.01±4.42)mm和(8.41±1.23)mm、(235.49±96.63)g和(110.01±22.36)g、(1260.21±66.47)ms和(1195.28±37.48)ms],差异均有统计学意义(P值均<0.01)。C组初始T 1-mapping值及ECV值最高,增强后T 1-mapping最低,A、B、C、D四组间差异均具有统计学意义(P<0.05)。结论:心脏MRI T 1-mapping值和ECV值可定量评估HCM的心肌组织学特征。Objective:To investigate the characteristics of longitudinal relaxation time quantitative imaging(T 1-mapping)and extracellular volume(ECV)in patients with hypertrophic cardiomyopathy(HCM).Methods:Fifty-six HCM patients and 30 healthy volunteers who underwent 3.0T cardiac MRI were prospectively collected.The maximum left ventricular wall thickness at end-diastole,myocardial mass,initial and post-contrast T 1-mapping values,and the ECV values of 16 myocardial segments in the two groups were measured.The differences between HCM groups and normal control groups,and between HCM subgroups were compared.Results:The 56 patients in the HCM group had a total of 896 segments,which were divided into 260 hypertrophic and enhanced segments(group A),145 hypertrophic and unenhanced segments(group B),15 non-hypertrophic and enhanced segments(group C),and 476 non-hypertrophic and unenhanced segments(group D).The maximum end-diastolic left ventricular wall thickness,myocardial mass,and initial T 1-mapping values were all higher in the HCM group than those in the normal control group(21.01±4.42)mm vs.(8.41±1.23)mm,(235.49±96.63)g vs.(110.01±22.36)g,and(1260.21±66.47)ms vs.(1195.28±37.48)ms,respectively,all P<0.01.The initial T 1-mapping and ECV values were the highest,and the post-contrast T 1-mapping was the lowest in group C,and the differences between the four groups were statistically significant(P<0.05).Conclusion:Cardiac MR T 1-mapping and ECV values can quantitatively evaluate the myocardial histological features of HCM.

关 键 词：肥厚型心肌病 磁共振成像 T 1-mapping 细胞外容积 延迟强化 

分 类 号：R542.2[医药卫生—心血管疾病] R445.2[医药卫生—内科学]