心脏磁共振IVIM成像定量评估肥厚型心肌病患者左心室壁肥厚程度的价值及临床意义  

Value and Clinical Significance of Cardiac Magnetic Resonance IVIM Imaging for Quantitative Assessment of Left Ventricular Wall Hypertrophy in Patients with Hypertrophic Cardiomyopathy

作　　者：郭小会 冷琦[1] GUO Xiao-hui;LENG Qi(Department of Radiology,Daxing District People's Hospital,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院放射科,北京102600

出　　处：《中国CT和MRI杂志》2023年第9期42-45,共4页Chinese Journal of CT and MRI

基　　金：北京市卫生科技发展专项基金项目(2019-2-929)。

摘　　要：目的探讨心脏磁共振IVIM成像(CMR-IVIM)对肥厚型心肌病(HCM)患者左心室壁肥厚程度的评估价值,以期为临床制定干预方案提供依据。方法选取我院2021年9月至2022年9月HCM患者55例(共880个心肌节段)作为研究对象,均行CMR-IVIM检查,对比左心室壁有无心肌肥厚节段、不同肥厚程度节段CMR-IVIM定量参数[快速表观扩散系数(ADC_(fast))、快速扩散成分所占比例(f值)、慢速表观扩散系数(ADC_(slow))],分析各参数与左心室壁肥厚程度的相关性及评估价值。结果左心室壁心肌肥厚节段f值、ADC_(fast)、ADC_(slow)低于无心肌肥厚节段(P<0.05);极重度、重度肥厚节段f值、ADC_(fast)、ADC_(slow)<中度肥厚节段<轻度肥厚节段(P<0.05);Pearson相关性分析,f值、ADC_(fast)、ADC_(slow)与左心室壁肥厚程度呈负相关(r=-0.563、-0.471、-0.408,P<0.05);f值、ADC_(fast)、ADC_(slow)诊断心肌肥厚节段的AUC分别为0.730、0.756、0.723,联合诊断AUC为0.903;f值、ADC_(fast)、ADC_(slow)评估中度肥厚节段AUC分别为0.769、0.739、0.773,联合评估AUC为0.900;f值、ADC_(fast)、ADC_(slow)评估重度及以上肥厚节段AUC分别为0.713、0.721、0.756,联合评估AUC为0.923。结论CMR-IVIM各定量参数与HCM患者左心室壁肥厚密切相关,临床可通过各参数进行早期诊断、评估左心室壁肥厚程度,为针对性制定后续治疗方案提供参考,以降低负性心血管事件发生风险。ObjectiveTo investigate the value of cardiac magnetic resonance IVIM imaging(CMR-IVIM)in assessing the degree of left ventricular wall hypertrophy in patients with hypertrophic cardiomyopathy(HCM),in order to provide a reference for early clinical assessment of the disease and formulation of treatment plans.Methods55 patients with HCM(a total of 880 myocardial segments)from september 2021 to september 2022 in our hospital were selected as study subjects,all of whom underwent CMR-IVIM examination to compare the presence or absence of hypertrophic segments in the left ventricular wall,quantitative CMR-IVIM parameters[proportion of fast diffusion components(f value),fast apparent diffusion coefficient(ADC_(fast)),slow apparent diffusion coefficient(ADC_(slow))]in segments with different degrees of hypertrophy,and to analyze the correlation and assessment value of each parameter with the degree of left ventricular wall hypertrophy.Resultsf-value,ADC_(fast),and ADC_(slow)were lower in left ventricular wall hypertrophy segments than in non-hypertrophy segments(P<0.05);f-value,ADC_(fast),and ADC_(slow)in very severe and severe hypertrophy segments<moderate hypertrophy segments<mild hypertrophy segments(P<0.05);Pearson correlation analysis,f-value,ADC_(fast),and ADC_(slow)were negatively correlated with the degree of LV wall hypertrophy(r=-0.563,-0.471,-0.408,P<0.05).The AUCs of f-value,ADC_(fast),and ADC_(slow)for diagnosing myocardial hypertrophy segments were 0.730,0.756,and 0.723,respectively,and the combined diagnostic AUC was 0.903;the AUCs of f-value,ADC_(fast),and ADC_(slow)for assessing moderate hypertrophy segments were 0.769,0.739,and 0.773,respectively,and the combined assessment AUC was 0.900;the AUCs of f value,ADC_(fast),and ADC_(slow)assessed AUCs of 0.713,0.721,and 0.756 for severely hypertrophic segments and 0.923 for the joint assessment,respectively.ConclusionThe quantitative parameters of CMR-IVIM are closely related to left ventricular wall hypertrophy in HCM patients,which can be used for early dia

关 键 词：心脏磁共振 IVIM成像 肥厚型心肌病 左心室壁肥厚 

分 类 号：R445.2[医药卫生—影像医学与核医学]