心脏MRI延迟强化联合T_(1) Mapping技术在高血压性心脏病心肌纤维化评价中的应用价值  

The application of CMR LGE combined with T_(1) Mapping technique in the evaluation of myocardial fibrosis in hypertensive heart disease

作　　者：赵猛[1] 李志强[1] 曹强[1] 张晓[1] ZHAO Meng;LI Zhiqiang;CAO Qiang;ZHANG Xiao(Department of Radiology,Binzhou People's Hospital,Binzhou 256610,China)

机构地区：[1]山东省滨州市人民医院放射科,山东滨州256610

出　　处：《医学影像学杂志》2022年第11期1897-1901,共5页Journal of Medical Imaging

基　　金：山东省医药卫生科技发展计划项目(编号:202009011110);山东省滨州市科技发展计划项目(编号:2015ZC0327)。

摘　　要：目的探讨联合利用心脏MRI延迟强化技术(LGE)和T_(1) Mapping技术对高血压性心脏病心肌纤维化进行半定量、定量评价,并探讨LGE与T_(1) Mapping技术在评价心肌纤维化中的区别。方法选取符合高血压诊断标准(此标准参照中国基层高血压诊疗指南)的患者147例组成病例组,同时纳入血压正常的健康志愿者86例组成对照组。两组均完成了3.0T心脏MRI扫描,扫描包括心脏结构扫描、动态电影扫描、心肌灌注扫描、LGE及T_(1) Mapping扫描,定量数据由Medis Suit心脏模块进行后处理并计算细胞外间隙容积(ECV)。结果病例组LGE阳性数为44例(29.9%),对照组LGE阳性数为0例(0%)。病例组平均T_(1)值为(1243.88±59.06),ECV值为(0.33±0.04);对照组平均T_(1)值为(1187.35±47.43),ECV值为(0.27±0.04),两组对比差异均具有统计学意义(P<0.05)。将病例组分为LGE阳性组(44例)和阴性组(103例),LGE阳性组平均左心室射血分数(LVEF%)为(43.21±5.13)%,平均T_(1)值为(1288.54±57.33),ECV值为(0.36±0.03);LGE阴性组平均左心室射血分数(LVEF%)为(58.41±6.35)%,平均T_(1)值为(1211.36±52.17),ECV值为(0.31±0.04),两组对比差异均具有统计学意义(P<0.05)。结论联合利用心脏MRI LGE技术、T_(1) Mapping技术可精确评价高血压性心脏病心肌纤维化的程度,是临床诊断、治疗高血压性心脏病的一种影像学手段。Objective To evaluate the myocardial fibrosis of hypertensive heart disease semi quantitatively and quantitatively by using cardiac MRI delayed enhancement(LGE)and T_(1) mapping,and to explore the difference between LGE and T_(1) mapping in evaluating myocardial fibrosis.Methods A total of 147 patients who met the diagnostic criteria of hypertension(the criteria refer to the guidelines for diagnosis and treatment of primary hypertension in China)were included in the case group,and 86 healthy volunteers with normal blood pressure were included in the control group.Both groups were completed 3.0T cardiac MRI scanning.The scanning protocol included cardiac structure scanning,dynamic cine scanning,myocardial perfusion scanning,LGE and T_(1) mapping scanning.The quantitative data were post processed by MEDIS suit heart module and the extracellular space volume(ECV)was calculated.Results The positive rate of LGE was 29.9%in the case group and 0%in the control group.The average T_(1) value of case group was(1243.88±59.06),ECV value was(0.33±0.04);the average T_(1) value of control group was(1187.79±47.43),ECV value was(0.31±0.04),ECV value was(0.27±0.04),and the difference was statistically significant(P<0.05).The patients were divided into LGE positive group(44 cases)and LGE negative group(103 cases).The average left ventricular ejection fraction(LVEF%)of LGE positive group was(43.21±5.13%),the average T_(1) value was(1288.54±57.33),the ECV value was(0.36±0.03);the average left ventricular ejection fraction(LVEF%)of LGE negative group was(58.41±6.35%),the average T_(1) value was(1211.36±52.17),the ECV value was(0.31±0.04).The difference was statistically significant(P<0.05).Conclusion The combined use of cardiac MRI LGE technology and T_(1) mapping technology can accurately evaluate the degree of myocardial fibrosis in hypertensive heart disease,which is a potentially im-portant imaging method for clinical diagnosis and treatment of hypertensive heart disease.

关 键 词：磁共振成像 高血压心脏病 延迟强化 细胞外间隙容积 

分 类 号：R541.3[医药卫生—心血管疾病] R445.2[医药卫生—内科学]