非酒精性脂肪肝病MR mDixon脂肪分数与左室心肌应变的相关性:早期心功能改变探索  

Correlation of MR mDixon fat fraction and left ventricular myocardial strain in non-alcoholic fatty liver disease:an exploration of early cardiac function changes

作　　者：马运婷 郑月 赵晓莹 王璐静 赵新湘[1] MA Yun-ting;ZHENG Yue;ZHAO Xiao-ying(Radiology Department,Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院放射科,昆明650101

出　　处：《放射学实践》2023年第3期279-284,共6页Radiologic Practice

基　　金：云南省重大专项项目(202203AC100007);国家自然科学基金(82160332);昆医联合专项-重点项目(202201AY070001-097);北京医学奖励基金会课题研究项目(YXJL-2022-0665-0214);昆医附二院院内临床研究项目(ynllT2021010)。

摘　　要：目的:采用心脏磁共振特征追踪(CMR-FT)技术探索非酒精性脂肪肝病(NAFLD)患者早期心功能是否改变,并分析NAFLD患者的MR mDixon肝脏脂肪分数(HFF)与左室心肌应变的相关性。方法:纳入左室射血分数正常(LVEF≥50%)的NAFLD患者和性别、年龄相匹配的健康志愿者(对照组)。所有纳入者均行CMR检查,利用CMR-FT分析三个方向的整体应变及应变率,即:整体纵向应变(GLS)、整体周向应变(GCS)、整体径向应变(GRS)、舒张期整体纵向峰值应变率(GLPDSR)、舒张期整体周向峰值应变率(GCPDSR)、舒张期整体径向峰值应变率(GRPDSR)、收缩期整体纵向峰值应变率(GLPSSR)、收缩期整体周向峰值应变率(GCPSSR)、收缩期整体径向峰值应变率(GRPSSR)。结果:NAFLD组25例,对照组25例。与对照组相比,NAFLD患者的GLS、GCS、GLPDSR、GCPDSR受损(均P<0.05),但GRS、GRPDSR、GLPSSR、GCPSSR、GRPSSR在两组间差异无统计学意义(均P>0.05)。Spearman相关性分析显示,NAFLD患者的HFF与GLPDSR、GCPDSR呈中度负相关(rs=-0.441、-0.466,P=0.027、0.019),与GLS、GCS、GRS、GRPDSR、GLPSSR、GCPSSR、GRPSSR无相关性(均P>0.05)。结论:在LVEF正常的NAFLD患者中,可以通过CMR-FT检测到患者早期左室功能障碍,且HFF与GLPSSR、GCPSSR呈中度负相关。Objective:To evaluate whether patients with non-alcoholic fatty liver disease(NAFLD)have early cardiac function changes assessing by cardiac magnetic resonance feature tracking(CMR-FT)technology,and to analyze the correlation between MR mDixon hepatic fat fraction(HFF)and left ventricular myocardial strain in patients with NAFLD.Methods:NAFLD patients with normal left ventricular ejection fraction(LVEF≥50%)a and sex-and age-matched healthy volunteers(control group)were included.All subjects underwent CMR examination,and CMR-FT was used to analyze the global strain and strain rate in three directions:global longitudinal strain(GLS),global circumstantial strain(GCS),global radial strain(GRS),global longitudinal peak diastolic strain rate(GLPDSR),global circumstantial peak diastolic strain rate(GCPDSR),global radial peak diastolic strain rate(GRPDSR),global longitudinal peak systolic strain rate(GLPSSR),global circumferential peak systolic strain rate(GCPSSR),global radial peak systolic strain rate(GRPSSR).Results:There were 25 patients in NAFLD group and 25 volunteers in control group.Compared with the control group,GLS,GCS,GLPDSR and GCPDSR were impaired in NAFLD patients(all P<0.05),but there was no significant difference in GRS、GRPDSR、GLPSSR、GCPSSR and GRPSSR between the two groups(all P>0.05).Spearman correlation analysis showed that the HFF of NAFLD patients was moderately negatively correlated with GLPDSR and GCPDSR(rs=-0.441,-0.466,P values were 0.027,0.019,respectively),but not correlated with GLS、GCS、GRS、GRPDSR、GLPSSR、GCPSSR、GRPSSR(all P>0.05).Conclusion:In NAFLD patients with normal LVEF,early left ventricular dysfunction can be detected by CMR-FT,and HFF is moderately negatively correlated with GLPSSR and GCPSSR.

关 键 词：非酒精性脂肪肝病 心脏磁共振 特征追踪技术 左心室 心肌应变 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学]