心脏磁共振组织追踪技术定量分析肥厚型心肌病左心室心肌应变  

Quantitative Analysis Left Ventricular Myocardial Strain in Hypertrophic Cardiomyopathy by Cardiac Magnetic Resonance Tissue Tracking Technique

作　　者：刘宗才[1] 刘新峰[1] 王荣品[1] 曾宪春[1] 刘昌杰[1] 杨艳[1] 翟茂雄[1] LIU Zongcai;LIU Xinfeng;WANG Rongpin(Department of Radiology,Guizhou Provincial People's Hospital,Guiyang,Guizhou Province 550002,P.R.China)

机构地区：[1]贵州省人民医院医学影像科,贵州省智能医学影像分析与精准诊断重点实验室,贵阳550002

出　　处：《临床放射学杂志》2022年第6期1025-1028,共4页Journal of Clinical Radiology

基　　金：贵州省卫健委科学技术基金项目(编号:gzwkj2021-373);贵州省科技成果应用及产业化计划项目(编号:黔科合成果[2019]4445号)。

摘　　要：目的基于心脏磁共振组织追踪技术(CMR-TT)定量分析肥厚型心肌病(HCM)患者左心室心肌应变。方法对HCM射血分数(EF)正常28例患者(病例组)及14名健康志愿者(对照组)行心脏磁共振电影检查,应用CMR-TT技术定量分析左心室心肌各向应变值、收缩期应变率及峰值位移,就两组左心室整体心肌的各向应变值、收缩期应变率、峰值位移及病例组肥厚节段、非肥厚节段应变参数做统计学分析,构建受试者工作特征(ROC)曲线,计算左心室整体心肌各向应变在鉴别对照组与病例组诊断效能。结果HCM组左心室整体心肌径向应变、周向应变、纵向应变值及其相应的应变率分别为(23.39±10.11)%和(1.32±0.48)s^(-1)、(-17.59±5.04)%和(-1.14±0.38)s^(-1)、(-8.70±2.84)%和(-0.59±0.20)s^(-1),均低于对照组。HCM组整体心肌径向、周向及纵向峰值位移分别为(4.32±0.97)mm、(2.63±1.74)deg、(4.43±1.81)mm也较对照组不同程度缩小。病例组肥厚节段径向应变、周向应变值低于非肥厚节段,分别为(9.12±2.97)%和(33.96±6.24)%、(-8.85±2.03)%和(-16.56±2.96)%(P均<0.05)。左心室整体心肌各向应变鉴别对照组与病例组敏感度均在85%以上。结论CMR-TT能够定量分析HCM患者左心室心肌应变,而且在鉴别健康志愿者与HCM患者中具有一定诊断价值。Objective Quantitative analysis of left ventricular strain in patients with hypertrophic cardiomyopathy based on cardiac magnetic resonance tissue tracking technique.Methods 28 patients with normal ejection fraction of HCM(case group)and 14 healthy volunteers(control group)were examined cardiac magnetic resonance cine examination.Left ventricular strain,systolic strain rate and peak displacement were analysed by MR tissue tracking technique.Two groups of left ventricular overall myocardial strain,systolic strain rate,peak displacement and case group hypertrophic segment,non hypertrophic segment strain were statistically analyzed.The ROC curve were constructed to calculate the diagnostic efficiency of left ventricular global myocardial strain in the differential diagnosis between control group and hypertrophic cardiomyopathy group.Results The radial strain,circumferential strain,longitudinal strain and strain rate in HCM group were(23.39±10.11)%and(1.32±0.48)s^(-1),(-17.59±5.04)%and(-1.14±0.38)s^(-1),(-8.70±2.84)%and(-0.59±0.20)s^(-1),which were lower than those in control group.The overall myocardial radial,circumferential and longitudinal peak displacements in HCM group were(4.32±0.97)mm,(2.63±1.74)deg and(4.43±1.81)mm respectively,which were also smaller than those in the control group.The radial strain and circumferential strain of hypertrophic segment in case group were lower than those of non hypertrophic segment,which were(9.12±2.97)%vs(33.96±6.24)%,(-8.85±2.03)%vs(-16.56±2.96)%(P<0.05).The sensitivity of strain identification in the whole left ventricular myocardium were above 85%in two groups.Conclusion CMR-TT can not only quantitatively analyze the left ventricular strain in patients with hypertrophic cardiomyopathy,but also has high diagnostic value in the differential diagnosis between normal group and hypertrophic cardiomyopathy group.

关 键 词：磁共振成像 组织追踪技术 心肌应变 肥厚型心肌病 

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