心脏磁共振心肌细胞外容积计算所需血细胞比容的时间窗研究  

Hematocrit Time Window of Cardiac Magnetic Resonance for Calculating Myocardial Extracellular Volume

作　　者：尹佳妮 徐怡[1] 朱晓梅[1] 周皛月 祝因苏[1] 邹建刚[3] YIN Jiani;XU Yi;ZHU Xiaomei;ZHOU Xiaoyue;ZHU Yinsu;ZOU Jiangang(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;不详)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]上海西门子医疗系统有限公司,上海201318 [3]南京医科大学第一附属医院心血管内科,江苏南京210029

出　　处：《中国医学影像学杂志》2023年第8期808-812,共5页Chinese Journal of Medical Imaging

摘　　要：目的 探讨心脏磁共振(CMR)进行心肌细胞外容积(ECV)计算所需血细胞比容(Hct)的时间窗从CMR检查24 h内扩展到检查前后7 d的可行性。资料与方法 回顾性分析2018年6月—2021年2月于南京医科大学第一附属医院行3T CMR且于24 h内、24 h~7 d、8~30 d及超过30 d分别测量Hct的81例患者。依据Hct与CMR检查相隔时间,将Hct分为24 h~7 d(Hct7)、8~30 d(Hct8~30)、>30 d(Hct>30)组,分别对应的ECV为ECV7、ECV8~30和ECV>30。上述Hct及ECV分别与标准Hct0及ECV0(即24 h内)进行比较和相关性分析,Hct的相关性分析采用Pearson相关系数,ECV的相关性分析采用Spearman相关分析;对不同时间窗Hct计算的ECV使用敏感度、特异度和准确度进行诊断效能评价。结果 Hct7、Hct8~30与Hct0比较,差异均无统计学意义(t=1.119、-1.338,P均>0.05),其中Hct7与Hct0的相关性更强(r=0.923,P<0.001);ECV7、ECV8~30与ECV0比较,差异均无统计学意义(Z=-1.150、-1.937,P均>0.05),其中ECV7与ECV0相关性更强(r=0.966,P<0.001)。Hct>30、ECV>30分别与Hct0、ECV0比较,差异均有统计学意义(t=-2.048,P=0.044;Z=-2.008,P=0.045)。以ECV0为标准,ECV7检测ECV增高(≥30%)的敏感度、特异度和准确度分别为97.1%、97.8%和97.5%。结论 CMR检查前后7 d的Hct可用于ECV的计算,时间窗超过1个月的Hct计算ECV与标准ECV存在差异且诊断效能下降,不推荐使用。Purpose To investigate the feasibility of extending the time window of hematocrit(Hct)from 24 hours to 7 days of cardiac magnetic resonance(CMR)scanning for calculating myocardial extracellular volume(ECV).Materials and Methods A total of 81 patients who underwent 3T CMR and had Hct measured within 24 hours,24 hours to 7 days,8 to 30 days and over 30 days at the First Affiliated Hospital with Nanjing Medical University from June 2018 to February 2021 were retrospectively analyzed.According to the interval between Hct and CMR,the Hct was divided into three groups:Hct7 group(24 hours to 7 days),Hct8-30 group(8 to 30 days),and Hct>30 group(more than 30 days),and the corresponding ECV included ECV7 group,ECV8-30 group,and ECV>30 group.The difference and correlation between the mentioned above Hct/ECV parameters and standard Hct0/ECV0(within 24 hours)were analyzed,respectively.Pearson correlation coefficient was used for Hct correlation analysis,and Spearman correlation analysis was used for ECV correlation analysis.The sensitivity,specificity and accuracy were used to evaluate the diagnostic efficacy of ECVs calculated by Hct with different time windows.Results There were no statistical differences in Hct between Hct7 and Hct0 groups,and Hct7 and Hct8-30 groups(t=1.119,-1.338,respectively;all P>0.05),with the better correlation between Hct0 and Hct7 groups(r=0.923,P<0.001).There was no statistical difference between ECV7 and ECV0 groups,and ECV7 and ECV8-30 groups(Z=-1.150,-1.937,respectively;all P>0.05),with the better correlation between ECV7 and ECV0 groups(r=0.966,P<0.001).Hct>30 and ECV>30 were significantly different from Hct0 and ECV0(t=-2.048,P=0.044;Z=2.008,P=0.045).According to ECV0 as the standard,the sensitivity,specificity and accuracy of ECV7 group in detecting increased ECV(≥30%)were 97.1%,97.8%and 97.5%,respectively.Conclusion Hct measured within 7 days of CMR examination can be used for the calculation of ECV.However,it is not recommended for Hct measured over 1 month to calculate ECV for its signi

关 键 词：磁共振成像 心脏病学 血细胞比容 

分 类 号：R54[医药卫生—心血管疾病] R445.2[医药卫生—内科学]