扩张型心肌病患者心肌应变与左心室球形指数相关性的初步研究  

A Preliminary Study on the Correlation Between Myocardial Strain and Left Ventricular Sphericity Index in Patients with Dilated Cardiomyopathy

作　　者：余鎏 夏睿 陶黎[2] 张志伟[2] 杨海涛[2] 李咏梅[2] 吕发金[2] YU Liu;XIA Rui;TAO Li;ZHANG Zhiwei;YANG Haitao;LI Yongmei;LV Fajin(Department of Radiology,The People’s Hospital of Kaizhou District,Chongqing 405400,China;Department of Radiology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆市开州区人民医院放射科,重庆405400 [2]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《中国医疗设备》2021年第10期113-116,共4页China Medical Devices

基　　金：国家自然科学基金青年项目(81601546)。

摘　　要：目的应用MRI心肌应变技术研究扩张型心肌病(Dilated Cardiomyopathy,DCM)患者整体心肌应变特点,并与左心室球形指数进行相关性分析。方法31例DCM患者以及23例正常志愿者进行MRI检查,完成电影序列扫描测量左心室射血分数(Left Ventricle Ejection Fraction,LVEF)及舒张末期容积,然后经患者肘正中静脉按0.1 mmol/kg体质量注入钆喷酸葡胺磁共振对比剂,10 min后扫描对比剂延迟增强图像,基于电影序列采用商用后处理软件测量心肌整体应变参数,包括整体纵向应变(Overall Longitudinal Strain,GLS)、整体圆周应变(Overall Circumferential Strain,GCS)、整体径向应变(Overall Radial Strain,GRS),同时计算左心室球形指数。结果DCM患者射血分数明显低于正常对照组,整体应变参数均低于正常对照组,球形指数高于正常对照组(P值均<0.01);DCM患者GLS与球形指数存在线性相关关系(P<0.05),LVEF、GCS、GRS与球形指数之间不存在相关关系(P>0.05)。结论磁共振心肌应变技术中,GLS较GRS与GCS相比更适合评估DCM心肌重构的程度,在球形指数以外提供了另一个评估左室心肌重构的定量指标,也为GLS可用于临床预测DCM患者发生心血管事件风险提供了形态学依据。Objective To investigate the characteristics of global myocardial strains with dilated cardiomyopathy(DCM)and to analyze its correlation with the left ventricular sphericity index.Methods 31 DCM patients and 23 normal volunteers were investigated by MRI.After the left ventricular ejection fraction(LVEF)and end diastolic volume(EDV)were measured by cine sequence scanning,magnetic resonance contrast agent(GD DTPA)was injected into the median cubital vein of the patient(0.1 mmol/kg body weight).The contrast agent delayed enhancement image(LGE)was collected 10 minutes after,based on the film sequence,global strain parameters of myocardium,including global longitudinal strain(GLS),global circumferential strain(GCS)and global radial strain(GRS),were measured by commercial post-processing software,and the left ventricular spherical index was calculated.Results The ejection fraction of DCM patients was significantly lower than that of normal control group,the overall strain parameters were lower than that of normal control group,and the spherical index was higher than that of normal control group(P<0.01);There was a linear correlation between GLS and spherical index in patients with DCM(P<0.05),but there was no correlation between left ventricular ejection fraction,GCS,GRS and spherical index(P>0.05).Conclusion Compared with GRS and GCS,GLS is more suitable for evaluating the degree of myocardial remodeling in DCM.Compared with spherical index,it can provide additional quantitative indicators.It is also expected to be used to predict the risk of cardiovascular events in patients with DCM based on morphology.

关 键 词：扩张型心肌病 磁共振 心肌应变 球形指数 

分 类 号：R542.2[医药卫生—心血管疾病]