T_(1) mapping“一站式”评估AMI患者再灌后不同心肌组织的技术探索  

The Exploration of T_(1) mapping“One-Stop”Evaluation of Different Myocardial Tissues in Reperfused AMI Patients

作　　者：孙峥[1] 胡莹莹 赵丽[1] 吴芳[1] 卢洁[1] 刘志[2] SUN Zheng;HU Yingying;ZHAO Li(Department of Radiology and Nuclear Medicine,Xuanwu Hospital,Capital Medical University,Beijing 100053,P.R.China)

机构地区：[1]首都医科大学宣武医院放射与核医学科,北京100053 [2]首都医科大学宣武医院心脏科,北京100053 [3]解放军总医院第六医学中心放射诊断科,北京100048

出　　处：《临床放射学杂志》2022年第12期2295-2300,共6页Journal of Clinical Radiology

基　　金：首都医科大学教育教学改革研究课题项目(编号:2022JYY155);国家自然科学基金资助项目(编号:62172288);解放军总医院第六医学中心创新培育基金项目(编号:CXPY202014)。

摘　　要：目的应用心血管磁共振(CMR)T_(1) mapping序列,探讨其对急性心肌梗死(AMI)患者术后水肿心肌和梗死心肌的“一站式”识别与评估。方法回顾性分析2018年9月至2020年12月首都医科大学宣武医院收治的AMI患者30例。T_(1) mapping用于分别对比“黑血”T_(2)-短时间反转恢复(STIR)和钆对比剂延迟增强(LGE)序列。定性评价包含T1mapping对水肿心肌和梗死心肌的检出率及图像质量;定量评价包含水肿心肌、梗死心肌体积的一致性比较,以及心肌不同组织的细胞外体积分数(ECV)。结果T1mapping对水肿心肌和梗死心肌的检测率在患者水平达100%。在94%(225/240层)的有效诊断层面分析中,T_(1) mapping与T_(2)-STIR共有75层(73%),与LGE共有76层(79%)具备同等图像质量。T_(1) mapping对比T_(2)-STIR测得水肿心肌体积为(30.9±8.1)%LV vs.(30.5±7.3)%LV,[r=0.91,偏倚量为(-0.8±11.2)%],对比LGE测得梗死心肌体积为(18.7±7.5)%LV vs.(18.4±7.4)%LV,[r=0.94,偏倚量为(-1.4±10.6)%],具备较高的一致性。AMI患者梗死心肌ECV显著升高(69.2±11.8)%。结论T1mapping可补充增加T_(2)-STIR对水肿心肌,LGE对梗死心肌的诊断信心,“一站式”提供更多具有临床参考价值的影像依据。Objective Cardiovascular magnetic resonance T_(1) mapping sequence was used to explore the“one-stop”identification and evaluation of edema-based and infarcted myocardium in patients with reperfused acute myocardial infarction(AMI).Methods Thirty patients with AMI admitted to Xuanwu Hospital from September 2018 to December 2020 were retrospectively enrolled.T1mapping was used to compare black blood T_(2)-STIR and late gadolinium enhancement(LGE)sequences.The qualitative evaluation included the T1mapping detection rate of edema-based myocardium and infarcted myocardium and image quality;quantitative evaluation had the consistent comparison of edema-based,infarcted myocardium volume,and extracellular volume fraction(ECV)of different myocardial tissues.Results The detection rate of T1mapping for edema and infarcted myocardium was 100%at the patient level.In 94%(225/240 slices)of valid diagnostic slices analyzed,T1mapping shared 75 slices(73%)in T_(2)-STIR and 76 slices(79%)in LGE with the same image quality.The edematous myocardium measured by T1mapping compared with T_(2)-STIR was[(30.9±8.1)%LV vs.(30.5±7.3)%LV,r=0.91,bias=(-0.8±11.2)%],and the infarcted myocardium measured by LGE was[(18.7±7.5)%LV vs.(18.4±7.4)%LV,r=0.94,bias=(-1.4±10.6)%].Both were with high consistency.The ECV of infarcted myocardium in AMI patients was significantly increased by(69.2±11.8)%.Conclusion T1mapping can benefit the confidence of T_(2)-STIR in diagnosing edema and LGE in the diagnosis of infarcted,and“one-stop”provides additional imaging evidence with a clinical reference value.

关 键 词：心血管磁共振 T_(1)mapping 钆对比剂延迟增强 心肌梗死 心肌水肿 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.22[医药卫生—诊断学]