心脏磁共振T_(1)-Maping技术定量参数在肥厚型心肌病中的应用:初始T_(1)及ECV  

Application of Quantitative Parameters of CMR T_(1)-Maping in Hypertrophic Cardiomyopathy:Native T_(1) and ECV

作　　者：聂伟霞 高立 李涯 李亿华 赖树填 袁旭春 NIE Wei-xia;GAO Li;LI Ya;LI Yi-hua;LAI Shu-tian;YUAN Xu-chun(Fuwai Hospital Chinese Academy of Medical Sciences,Shenzhen 518000,Guangdong Province,China)

机构地区：[1]中国医学科学院阜外医院深圳医院放射科,广东深圳518000

出　　处：《中国CT和MRI杂志》2023年第5期49-51,共3页Chinese Journal of CT and MRI

基　　金：院士青年英才培育基金资助(YS-2019-016)。

摘　　要：目的 通过对比肥厚型心肌病患者与正常志愿者之间NativeTi值与ECV值,评估两者在肥厚型心肌病患者弥漫性心肌纤维化中的临床应用价值。方法 连续收集47例临床诊断为HCM的患者及24例正常志愿者行心脏磁共振成像(CMR)检查[包括心脏电影、增强前T_(1)-Maping、增强后T_(1)-Maping及延迟钆对比剂增强(LGE)]。经后处理计算Native T_(1)值及ECV值;同时观察肥厚型心肌病患者心肌LGE有无强化;病例组组与正常组间Native T_(1)及ECV值采用独立样本t检验,P<0.05有统计学意义;参数间的相关性采用Spearman相关分析;ROC曲线下面积评估其诊断效能。根据肥厚段心肌有无延迟强化,将病例组分为LG E(+)组和LGE(-)组,并对比两组之间的NativeT_(1)值与ECV值。结果 病例组Native T_(1)及ECV高于正常组,两组间NativeT_(1)、 ECV值差异具有统计学意义;NativeT_(1)值[(1297.148±66.800)ms:(1113.375±98.637),P=0.019];ECV值[(37.829±6.850)%:(33.666±3.952)%,P=0.016];LGE(+)组Native T_(1)及ECV高于LGE(-)组,差异无显著统计学意义;两参数间S pearman相关分析,NativeT_(1)值与ECV值具有正相关关系[r=0.566,P<0.001];ROC曲线,NativeT_(1)[AUC=0.909,灵敏性79.2%、特异性95%],ECV[AUC=0.673,灵敏性66.7%、特异性66.0%],NativeT_(1)诊断效能较高,两者差异具有统计学意义(P<0.01)。结论 磁共振T_(1)-Maping技术可以对肥厚型心肌病心肌纤维化进行定量诊断,其参数NativeT_(1)诊断效能优于ECV。Objective To evaluate the clinical value of NativeT_(1) and ECV in diffuse myocardial fibrosis in patients with hypertrophic cardiomyopathy.Methods Cardiac magnetic resonance imaging(CMR)was performed in 47 patients with clinically diagnosed HCM and 24 normal volunteers[including cardiac film,pre-enhanced T_(1)-Maping,post-enhanced T_(1)-Maping and delayed gadolinium contrast enhancement(LGE)].Calculate the NativeT_(1) value and ECV value;NativeT_(1) and ECV in patients with hypertrophic cardiomyopathy were observed.Independent sample t-test was used between the case group and the normal group,and the correlation between the parameters was analyzed by Spearman correlation analysis.The diagnostic efficiency was evaluated by the area under the ROC curve.According to whether the hypertrophic myocardium had delayed enhancement or not,the patients were divided into LGE(+)group and LGE(-)group,and the NativeT_(1) and ECV values between the two groups were compared.Results NativeT_(1) and ECV in the case group were significantly higher than those in the normal group,the difference was statistically significant,NativeT_(1) value[(1297.148±66.800)ms:(1113.375±98.637),P=0.019];ECV value[(37.829±6.850)%:(33.666±3.952)%,P=0.016];NativeT_(1) and ECV in the LGE(+)group were higher than those in the LGE(-)group,but the difference was not statistically significant.Spearman correlation analysis between the two parameters showed that there was a positive correlation between NativeT_(1) value and ECV value[r=0.56(P<0.001)];ROC curve,NativeT_(1)[AUC=0.909,sensitivity 79.2%,specificity 95%],ECV[AUC=0.673,sensitivity 66.7%,specificity66.0%].The diagnostic efficiency of ECV was higher,and the difference was statistically significant(P<0.001).Conclusion MRI T_(1)-Maping can quantitatively diagnose to myocardial fibrosis in hypertrophic cardiomyopathy,and NativeT_(1) has a better diagnostic efficiency than ECV.

关 键 词：肥厚型心肌病 T_(1)-Maping NativeT_(1)值 ECV LGE 

分 类 号：R445.2[医药卫生—影像医学与核医学]