心脏磁共振成像联合心肌应变分析在心尖肥厚型心肌病中的应用价值  

Application value of cardiac magnetic resonance imaging combined with myocardial strain analysis in apical hypertrophic cardiomyopathy

作　　者：代卫斌[1] 刘婷婷 史永艳[2] 孟延锋 DAI Weibin;LIU Tingting;SHI Yongyan;MENG Yanfeng(Department of Magnetic Resonance,Taiyuan Central Hospital,Shanxi Province,Taiyuan030009,China;Department of Cardiovascular Medicine,Taiyuan People′s Hospital,Shanxi Province,Taiyuan030001,China)

机构地区：[1]太原市中心医院磁共振室,山西太原030009 [2]太原市人民医院心血管内科,山西太原030001

出　　处：《中国当代医药》2022年第28期5-8,18,共5页China Modern Medicine

基　　金：国家自然科学基金面上项目(81671789);山西省卫生健康委科研课题(2022113);山西省基础研究计划项目(202103021224003)。

摘　　要：目的探讨心脏磁共振成像联合心肌应变分析在心尖肥厚型心肌病(AHCM)中的应用价值,比较AHCM患者与正常对照组左心室形态、功能及心尖部心肌应变的差异。方法回顾性选取2017年9月至2021年7月太原市中心医院磁共振室诊断的10例AHCM患者作为AHCM组,另选取同期20名健康志愿者作为对照组,获取心脏磁共振影像,使用cvi42图像软件进行分析,比较两组左心室功能参数、心尖角及心尖部心肌应变参数间的差异。结果AHCM组的心尖角小于对照组,差异有统计学意义(P<0.01)。AHCM组的射血分数(LVEF)、舒张末期容积指数(EDV/BSA)、每搏输出量指数(SV/BSA)、心肌质量指数(LVM/BSA)均高于对照组,收缩末期容积指数(ESV/BSA)低于对照组,差异有统计学意义(P<0.01)。AHCM组的纵向峰值应变、舒张期纵向峰值应变率均低于对照组,收缩期周向峰值应变率高于对照组,差异有统计学意义(P<0.01)。两组的周向峰值应变、径向峰值应变、收缩期纵向峰值应变率、收缩期径向峰值应变率、舒张期周向峰值应变率、舒张期径向峰值应变率比较,差异无统计学意义(P>0.05)。结论心脏磁共振成像联合心肌应变分析可以定量评估AHCM左心室形态及功能,有助于深入了解心功能异常的病理生理学机制,为疾病的诊断和治疗后评估提供依据。Objective To explore the application value of cardiac magnetic resonance imaging combined with myocardial strain analysis in apical hypertrophic cardiomyopathy(AHCM),and to compare the differences of left ventricular morphology,function and apical myocardial strain between AHCM patients and normal people.Methods Ten AHCM patients diagnosed in the magnetic resonance room of Taiyuan Central Hospital from September 2017 to July 2021 were retrospectively selected as AHCM group,and 20 healthy volunteers in the same period were selected as control group.Cardiac magnetic resonance images were obtained and analyzed using cvi42 image software to compare the differences between the two groups in left ventricular function parameters,apical angle and apical myocardial strain parameters.Results The apical angle in AHCM group was smaller than that in control group,the difference was statistically significant(P<0.01).The left ventricular ejection fraction(LVEF),end diastolic volume/body surface area(EDV/BSA),stroke volume/body surface area(SV/BSA)and left ventricular mass/body surface area(LVM/BSA)in AHCM group were higher than those in control group,while end systolic volume/body surface area(ESV/BSA)in AHCM group was lower than that in control group,the differences were statistically significant(P<0.01).The longitudinal peak strain and longitudinal peak strain rate in AHCM group were lower than those in control group,and the peak strain rate in the systolic period was higher than that in control group,the differences were statistically significant(P<0.01).There were no significant differences in radial peak strain rate,the longitudinal peak strain rate in systolic phase,the radial peak strain rate in systolic phase,the radial peak strain rate in diastolic phase and the radial peak strain rate in diastolic phase between the two groups(P>0.05).Conclusion Cardiac magnetic resonance imaging and myocardial strain analysis can quantitatively evaluate the left ventricle morphology and function of AHCM.It is helpful to deeply underst

关 键 词：磁共振成像 心肌应变 肥厚型心肌病 心尖肥厚 

分 类 号：R445.2[医药卫生—影像医学与核医学]