特征追踪心脏MRI定量评估非梗阻性肥厚型心肌病左房功能的应用研究  

Application study of feature tracking cardiac MRI quantitative assessment of left atrial function in non-obstructive hypertrophic cardiomyopathy

作　　者：薛迪[1] 吴江 李璇 梁秀琴 XUE Di;WU Jiang;LI Xuan(The Institute of Medical Imaging of Shanxi Medical University,Taiyuan 030001,China;不详)

机构地区：[1]山西医科大学医学影像学院,山西太原030001 [2]山西省心血管病医院磁共振室,山西太原030024

出　　处：《放射学实践》2024年第4期479-487,共9页Radiologic Practice

基　　金：磁共振心肌应变分析在少见心肌病的应用研究(2020038)。

摘　　要：目的:应用特征追踪心脏MRI(FT-cMRI)对非梗阻性肥厚型心肌病(NOHCM)患者进行左房应变分析来评估左心房功能,并探究NOHCM对左心结构和功能的影响。方法:回顾性分析2020年1月-2022年12月本院58例非梗阻性肥厚型心肌病患者(NOHCM组)和30例健康对照者(HC组)的临床和MRI资料。MRI扫描序列主要为单次激发FSE亮血序列,扫描平面包括两腔、四腔和短轴位。应用CVI42软件测量左房容积指数(LAVI)和左房整体功能参数,后者包括心肌储备功能参数[总应变(εs)、峰值正向应变率(SRs)、左房总射血分数(LATEF)]、导管功能参数[主动应变(εe)、峰值早期负向应变率(SRe)、左房被动射血分数(LAPEF)]和升压泵功能参数[被动应变(εa)、峰值晚期负向应变率(SRa)、左房主动射血分数(LAAEF)],以及左室的功能[左室射血分数(LVEF)、左室心输出量(LVCO)和左室心脏指数(LVCI)]和大小参数[左室最大室壁厚度(LVWT_(max))、左室心肌质量(LVM)、左室质量指数(LVMI)、左室舒张末期容积指数(LVEDVi)和左室收缩末期容积指数(LVESVi)]。采用两样本t检验、Mann-Whitney U检验等统计学方法比较两组间各项定量参数值的差异,并采用Pearson或Spearman相关系数分析左房功能参数与左室的结构和功能参数之间的相关性。结果:NOHCM组的LVWT_(max)、LVM、LVMI和LAVI值均显著高于HC组(P<0.05),NOHCM组的左房功能参数值(LATEF、LAPEF、LAAEF、εs、εe、εa,SRs、SRe和SRa)均显著低于HC组(P<0.05)。NOHCM组左室心肌不同肥厚部位的LVWT_(max)的差异有统计学意义(P<0.05),两组之间其它的左房、左室结构和功能参数值的差异无统计学意义(P>0.05)。左房大小正常的NOHCM患者的LATEF、LAPEF、εs、εe、SRs和SRe值均显著低于HC组(P<0.05),而LAAEF、εa和SRa值在两组之间的差异无统计学意义(P>0.05)。所有受试者的LATEF与εs、LAPEF与εe、LAAEF与εa之间均具有显著相关性(r>0.70)。结论:与健Objective:To explore value of the feature tracking cardiac magnetic resonance imaging(FT-cMRI)in assessing left atrial function by performing left atrial strain analysis in patients with non-obstructive hypertrophic cardiomyopathy(NOHCM)and to investigate the effects of NOHCM on left atrial and left ventricular structure and function.Methods:The clinical and MRI data of 58 patients with non-obstructive hypertrophic cardiomyopathy(NOHCM group)and 30 healthy controls(HC group)from January 2020 to December 2022 in our hospital were retrospectively analyzed.The main sequence for cMRI examination was bright blood technique with single shot fast spin-echo.The scanning planes were two-chamber,four-chamber,and short-axis positions.CVI42 software was used to measure left atrium volume index(LAVI),overall cardiac functional parameters including the re-servoir function[total strain(εs),peak positive strain rate(SRs),left atrial total ejection fraction(LATEF)],conduit function[passive strain(εe),peak early negative strain rate(SRe),left atrial passive ejection fraction(LAPEF)],and booster pump function[active strain(εa),peak late negative strain rate(SRa),left atrial active ejection fraction(LAAEF)],and left ventricular function parameters[left ventricular ejection fraction(LVEF),left ventricular cardiac output(LVCO),left ventricular cardiac index(LVCI)]and left ventricular size parameters[(left ventricular maximum wall thickness(LVWT_(max)),left ventricular mass(LVM),left ventricular mass index(LVMI),left ventricular end-diastolic volume index(LVEDVi),left ventricular end-systolic volume index(LVESVi)].Statistical methods such as paired-sample t-test and Mann-Whitney U-test were used to compare the differences in the values of each quantitative parameter between the two groups.Pearson or Spearman correlation coefficient was used to analyze the correlation between the values of the left atrial functional parameters and the values of the structural and functional parameters of the left ventricle.Results:The values of LVWT_

关 键 词：肥厚型心肌病 左房应变 左房功能 特征追踪技术 心脏磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]