磁共振心肌应变定量评价心肌淀粉样变及与心肌初始T1值和ECV值的相关性分析  

Value of MRI Myocardial Strain in Cardiac Amyloidosis and its Correlation with Native T1 and Extracellular Volume Fraction

作　　者：刘雨蒙[1] 朱静芬[1] 陈蒙[1] 汪灵杰[1] 朱默[1] 胡春洪[1] LIU Yumeng;ZHU Jingfen;CHENG Meng;WANG Lingjie;ZHU Mo;HU Chunhong(Department of Radiology,The First Affiliated Hospital,Soochow University)

机构地区：[1]苏州大学附属第一医院放射科

出　　处：《中国医学计算机成像杂志》2021年第6期516-522,共7页Chinese Computed Medical Imaging

摘　　要：目的:探讨磁共振心肌应变定量评价心肌淀粉样变性(CA)价值及与心肌初始T1值和细胞外容积分数(ECV)值的相关性。方法:对30例CA患者(CA组)、10例可疑CA患者(可疑CA组)、20例肥厚型心肌病患者(HCM组)及40名健康志愿者(健康对照组)行3.0T心脏磁共振检查(CMR),扫描序列包括心脏电影、T1mapping、钆对比剂延迟强化(LGE)。在心脏电影图像上进行心肌应变分析,得到左室整体及各区域层面的3D径向应变(RS)、周向应变(CS)和纵向应变(LS)值。通过T1mapping图像获得心肌初始T1值和ECV值。对各组间上述参数进行对比分析,并将CA患者的心肌应变值与心肌初始T1值和ECV值进行相关性分析。结果:CA组的左室心肌各层面及总体的RS、CS、LS绝对值均低于HCM组和健康对照组(P<0.05);且与健康对照组相比,可疑CA组的总体RS、CS、LS绝对值均减低(P<0.05)。CA患者左室总体RS值与心肌初始T1值(r=-0.775,P<0.001)及ECV值(r=-0.659,P<0.001)均呈负相关;左室总体CS值与心肌初始T1值(r=0.883,P<0.001)及ECV值(r=0.772,P<0.001)均呈正相关;左室总体LS值与心肌初始T1值(r=0.854,P<0.001)及ECV值(r=0.765,P<0.001)均呈正相关。结论:磁共振心肌应变可以定量评价CA患者心肌形变程度,且与心肌初始T1值和ECV值具有较好的相关性。Purpose: To evaluate the value of magnetic resonance imaging(MRI) myocardial strain in patients with cardiac amyloidosis(CA) and its correlation with native T1 and extracellular volume fraction(ECV).Methods:Thirty patients with definite CA and 10 with possible CA underwent 3.0 T MRI including cine, T1 mapping and late gadolinium enhancement(LGE) imaging. Myocardial strain analysis including RS(radial strain), CS(circumferential strain) and LS(longitudinal strain) parameters were applied on cine imaging. Native T1 and ECV were acquired by T1 mapping. All these parameters were compared among 30 patients with definite CA, 10 patients with possible CA,20 patients with hypertrophic cardiomyopathy(HCM) and 40 healthy volunteers. Correlation analysis was performed between myocardial strain, native T1 and ECV in patients with CA. Results: The patients with definite CA demonstrated significantly reduced RS, CS and LS values compared to patients with HCM and healthy volunteers.The RS, CS and LS values of patients with possible CA were also reduced when compared to healthy volunteers.Among all CA patients, there were significantly negative correlation between RS and native T1(r=-0.775, P<0.001),RS and ECV(r=-0.659, P<0.001). CS showed positive correlation with native T1(r=0.883, P<0.001) and ECV(r=0.772, P<0.001). LS also showed positive correlation with native T1(r=0.854, P<0.001) and ECV(r=0.765, P<0.001).Conclusion: MRI myocardial strain is valuable in patients with CA and has close correlation with native T1 and ECV.

关 键 词：心脏磁共振 心肌应变 心肌淀粉样变 T1 mapping 细胞外容积分数 

分 类 号：R445.2[医药卫生—影像医学与核医学]