延迟钆剂磁共振显像在评价扩张型心肌病患者功能中的应用  

Application of LGE-CMR in evaluating the function of patients with dilated cardiomyopathy

作　　者：李海明 张新成 冯长明 LI Hai-ming;ZHANG Xin-cheng;FENG Chang-ming(Department of Imaging,Hebei Central Hospital of Petrochina,Langfang Hebei 065000,China)

机构地区：[1]河北中石油中心医院影像科,河北廊坊065000

出　　处：《中国临床医学影像杂志》2024年第2期105-108,共4页Journal of China Clinic Medical Imaging

基　　金：2020年廊坊市科学技术研究与发展计划(第一批)自筹经费项目(编号:2020013091)。

摘　　要：目的:探究延迟钆剂磁共振显像(LGE-CMR)在评价扩张型心肌病(DCM)患者功能中的应用价值。方法:选择2020年1月—2023年5月医院收治的DCM患者87例,均接受心脏磁共振成像检查(CMR),包括电影成像、LGE-CMR检查,分析扫描结果,评价有无LGE与美国纽约心脏病协会(NYHA)心功能分级、CMR检查心功能参数的关系。结果:87例患者LGE阳性率为41.38%(36/87),LGE(+)者心肌延迟强化节段161个,累及最多的心肌节段为基底部前间壁和下间壁,强化形态以肌壁间线性为主;LGE(+)者NYHA心功能分级劣于和LGE(-)者(P<0.05),左室舒张末期容积标准化校正(LVEDVI)、左室收缩末期容积标准化校正(LVESVI)水平显著高于LGE(-)者(P<0.05),左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、左心室球形指数(LVSI)水平显著低于LGE (-)者(P<0.05);LGE (+)节段数与NYHA心功能分级、LVEDVI、LVESVI呈正相关关系(r=0.645,0.494,0.532,P<0.05),与LVEF、LVFS、LVSI呈负相关关系(r=-0.518,-0.574,-0.461,P<0.05)。结论 :LGE-CMR识别的LGE(+)反映心肌纤维化,LGE(+)与左心室重构后结构功能受损有关,LGE(+)累及节段数越多,心功能越差。Objective:To explor e the application value of late gadolinium enhancement-cardiac magnetic resonance imaging(LGE-CMR)on evaluating the function of patients with dilated cardiomyopathy(DCM).Methods:Eighty-seven patients with DCM admitted to the hospital from January 2020 to May 2023 were enrolled and underwent cardiac magnetic resonance imaging(CMR),including cine imaging and LGE-CMR.The scan results were analyzed to evaluate the relationship of absence or presence of LGE with New York Hearth Association(NYHA)cardiac function grading and CMR cardiac function parameters.Results:The positive rate of LGE in 87 patients was 41.38%(36/87).The patients with LGE(+)had 161 segments of delayed myocardial enhancement,and the most involved segments were the anterior and inferior walls of the base,and the morphology was mainly intermuscular linear.NYHA cardiac function grading of patients with LGE(+)was worse than that of patients with LGE(-)(P<0.05),and left ventricular end diastolic volume index(LVEDVI)and left ventricular end systolic volume index(LVESVI)were significantly higher than those of patients with LGE(-)(P<0.05)while left ventricular ejection fraction(LVEF),left ventricular fraction shortening(LVFS)and left ventricular sphericity index(LVSI)were significantly lower than those of patients with LGE(-)(P<0.05).The number of LGE(+)segments was positively correlated with NYHA cardiac function grading,LVEDVI and LVESVI(r=0.645,0.494,0.532,P<0.05),and was negatively correlated with LVEF,LVFS and LVSI(r=-0.518,-0.574,-0.461,P<0.05).Conclusion:LGE(+)identified by LGE-CMR reflects myocardial fibrosis,and LGE(+)is related to structural function impairment after left ventricular remodeling.The more LGE(+)involved segments,the worse cardiac function.

关 键 词：心肌病 扩张型 磁共振成像 

分 类 号：R542.2[医药卫生—心血管疾病] R445.2[医药卫生—内科学]