T_(1)弛豫时间及细胞外容积定量测定轻链型心肌淀粉样变性患者肝脾淀粉样蛋白负荷的初步研究  

A preliminary study of T_(1) mapping and extracellular volume quantitative in measurement of amyloid protein load in liver and spleen in patients with amyloid light-chain cardiac amyloidosis

作　　者：程连华 徐兴华[1] 王林红[1] 刘芹芹 王青[1] 王茜[1] CHENG Lianhua;XU Xinghua;WANG Linhong;Liu Qinqin;WANG Qing;WANG Qian(Department of Radiology,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院放射科,山东济南250012

出　　处：《中国中西医结合影像学杂志》2022年第4期344-349,共6页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨轻链型心肌淀粉样变性(AL-CA)患者行心脏MRI检查时,通过测量肝脏、脾脏的初始T_(1)值及细胞外容积分数(ECV)无创定量测定肝脏、脾脏淀粉样蛋白负荷的可行性。方法:回顾性分析15例经临床、活检证实的AL-CA患者(AL-CA组)及15例因胸闷不适就诊的受试者(对照组)的心脏MRI检查资料,评价初始T_(1) mapping及增强T_(1) mapping图像,测量心肌、肝脏、脾脏的初始T_(1)值、增强T_(1)值,并计算相应ECV值。结果:AL-CA组的心肌初始T_(1)值、ECV值,肝脏初始T_(1)值、ECV值,脾脏ECV值高于对照组(P<0.05),脾脏初始T_(1)值与对照组差异无统计学意义(P=0.621)。2组心肌ECV值与肝脏、脾脏ECV值均呈高度线性相关(r=0.761、0.717,均P<0.001)。结论:AL-CA患者在行心脏T_(1) mapping扫描的同时可获得肝脏及脾脏图像,通过测量肝脏、脾脏的初始T_(1)值及ECV值探测重要脏器中淀粉样蛋白的浸润,指导临床和跟踪治疗。Objective:To explore the feasibility of measuring the initial T_(1) value and extracellular volume fraction(ECV)in the determination of amyloid protein load in the liver and spleen in patients with amyloid light-chain cardiac amyloidosis(Al-Ca)when those patients underwent cardiac MRI.Methods:The cardiac MRI data of 15 patients with clinically diagnosed Al-Ca(Al-Ca group)and 15 participants with thoracic discomfort(control group)were analyzed retrospectively.The initial T_(1) mapping and enhanced T_(1) mapping images were evaluated.The initial T_(1) and enhanced T_(1) values of the myocardium,liver and spleen were measured,and the corresponding ECV values were calculated.Results:The initial T_(1) value and ECV value of the myocardium and liver and ECV value of the spleen in the Al-Ca group were higher than those in the control group(P<0.05).The initial T_(1) value of the spleen was no significant difference between the two groups(P=0.621).A high linear correlation existed between ECV value of myocardium and ECV of liver and spleen in two groups(r=0.761,0.717,both P<0.001).Conclusions:This study shows that,in the cardiac MRI examination,part of the liver and spleen can be included in T_(1) mapping images so that the amyloid infiltration of important organs can be detected by measuring the initial T_(1) value and calculating the ECV value.It is a useful tool in the noninvasive evaluation of visceral amyloid burden,which is helpful to guide clinical practice and follow-up treatment.

关 键 词：磁共振成像 淀粉样变性 细胞外容积 纵向弛豫时间 

分 类 号：R597.2[医药卫生—内科学] R445.2[医药卫生—临床医学]