心脏磁共振T1 mapping联合特征追踪技术在LGE阴性的肥厚型心肌病中的应用价值  

The Application Value of Cardiac Magnetic Resonance T1 Mapping Combined with Feature Tracking Technique in Hypertrophic Cardiomyopathy without LGE

作　　者：李杉 阿巴斯江·阿地力 齐海成 刘倩 栗岩 邢艳 LI Shan;ABASHIJIANG·Adili;QI Haicheng;LIU Qian;LI Yan;XING Yan(Imaging Center,The First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院影像中心,乌鲁木齐830054

出　　处：《中国医学计算机成像杂志》2023年第4期380-387,共8页Chinese Computed Medical Imaging

基　　金：国家自然科学基金(82160334);新疆维吾尔自治区区域协同创新专项(2021E02067)。

摘　　要：目的:探究心脏磁共振(CMR)T1 mapping技术联合特征追踪(FT)技术在钆对比剂延迟增强(LGE)阴性的肥厚型心肌病(HCM)患者心肌纤维化和心肌形变中的诊断效能与预测价值。方法:连续收集诊断为HCM且CMR检查为LGE阴性的患者17例及健康志愿者28例,所有研究对象均进行CMR扫描,所有图像均上传至Cvi42后处理软件,分析心功能参数、native T1值、细胞外间质容积分数(ECV)、T2值及左室整体纵向应变(GLS)、周向应变(GCS)和径向应变(GRS)峰值等指标之间的差异;采用受试者工作特征(ROC)曲线分析各参数诊断效能。结果:与正常对照组相比,HCM组左室射血分数(LVEF)降低,收缩期/舒张期的心肌质量升高,差异具有统计学意义(P<0.05);左心室整体、基底部、心尖部native T1值、ECV值及中间部T1值均升高(P<0.05);GCS、GRS、GLS峰值均降低,差异具有统计学意义(P<0.05)。整体ECV值的曲线下面积(AUC)为0.812、灵敏度为0.818、特异度为0.727、约登指数为0.545,提示整体ECV值诊断效能最高(P<0.05)。结论:LGE阴性患者的HCM患者的整体、基底部、中间部、心尖部native T1值及ECV值升高,提示HCM患者存在不同程度的弥漫性纤维化;LGE阴性的HCM患者GLS、GRS、GCS均下降,提示CMR-FT技术可以较早地反映心肌形变及心收缩功能受损。Purpose:To explore the diagnostic and predictive value of cardiac magnetic resonance T1 mapping combined with feature tracking(CMR-FT)technique in the quantitative analysis of myocardial fibrosis and myocardial deformation in patients with hypertrophic cardiomyopathy(HCM)without late-gadolinium enhancement(LGE).Methods:Serial collection of 17 patients with HCM without LGE and 28 healthy volunteers,all subjects underwent cardiac magnetic resonance scanning,and all images were uploaded to Cvi42 post-processing software to analyze the differences of the cardiac function parameters,native T1,extracellular volume(ECV),T2 and the global longitudinal strain(GLS)peak,global radial strain(GRS)peak,and global circumferential strain(GCS)peak between 2 groups.Results:Compared with the normal control group,(1)left ventricular ejection fraction(LVEF)was reduced and systolic/diastolic myocardial mass increased in HCM group,and the difference was with statistical significance(P<0.05);(2)the left ventricular global,basal base,apical native T1,ECV and middle T1 values were significantly increased(P<0.05)in HCM group;(3)the peak values of GCS,GRS and GLS were all reduced in HCM group,and the difference was with statistical significance(P<0.05).The area under the curve(AUC)of the global ECV value was 0.812 with sensitivity of 0.818,specificity of 0.727,and Jordon index of 0.545,indicating that the global ECV value was with the highest diagnostic efficiency(P<0.05).Conclusion:The native T1 and ECV values of HCM patients in LGE-negative patients were enormous,suggesting that patients with HCM had different degrees of diffuse fibrosis.Longitudinal strain,radial strain,and circumferential strain decreased in LGE-negative HCM patients,suggesting that CMR-FT technique can reflect myocardial deformation and impaired systolic function earlier.

关 键 词：心脏磁共振 T1 mapping 心脏磁共振特征追踪 肥厚型心肌病 

分 类 号：R445.2[医药卫生—影像医学与核医学]