心脏磁共振特征追踪技术在特发性室性心律失常患者中的应用研究  

Application research of cardiac magnetic resonance feature tracking technology in patients with idiopathic ventricular arrhythmias

作　　者：廖伟伟 钟俭平 LIAO Wei-wei;ZHONG Jian-ping(Medical Imaging Center,Ganzhou People's Hospital,Ganzhou Hospital Nanfang Hospital,Southern Medical University,The Affiliated Ganzhou Hospital of Nanchang University;Ganzhou Institute of Medical Imaging;Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence,Ganzhou,Jiangxi 341000)

机构地区：[1]赣州市人民医院,南方医科大学南方医院赣州医院,南昌大学附属赣州医院医学影像中心 [2]赣州市医学影像研究所 [3]赣州市医学影像与人工智能重点实验室,江西赣州341000

出　　处：《赣南医学院学报》2024年第3期248-254,共7页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：国家自然科学基金项目(82160330);江西省自然科学基金项目(20202ACBL216006);江西省卫生健康委员会科技计划项目(202140784);江西省医学影像临床医学研究中心项目(20223BCG7400199)。

摘　　要：目的:探讨心脏磁共振组织特征追踪技术(Cardiac magnetic resonance feature tracking,CMR-FT)早期评估特发性室性心律失常(Idiopathic ventricular arrhythmias,IVA)患者左心室功能障碍的价值。方法:回顾性纳入2018年1月至2023年5月心功能正常的IVA患者106例,根据24小时动态心电图将患者分为频发室性早搏组(PVCs组)和非持续性室性心动过速组(NSVT组),并选取同时期行CMR检查的健康志愿者40例为对照组。利用后处理软件测量左心室常规功能参数和心肌应变参数,包括左心室射血分数(Left ventricular ejection fraction,LVEF)、左心室舒张末期容积指数(Left ventricular end diastolic volume index,LVEDVI)、左心室收缩末期容积指数(Left ventricular end systolic volume index,LVESVI)、左心室心肌质量指数(Left ventricular myocardial mass index,LVMI)、左心室3个方向的心肌应变峰值及峰值应变率参数等。使用SPSS 26.0软件进行数据分析。结果:与NSVT组、对照组比较,PVCs组LVESVI值增加,而LVEF值减低(P<0.05)。IVA患者各组整体径向应变(Global radial strain,GRS)、整体周向应变(Global circumferential strain,GCS)、整体纵向应变(Global circumferential strain,GLS)、收缩期径向应变率峰值(Systolicradialstrainratepeak,SRSR)、收缩期周向应变率峰值(Systolic circumferential strain rate peak,SCSR)均低于对照组(P<0.05),PVCs组与NSVT组的GRS、GCS、GLS、SRSR、SCSR差异均有统计学意义(P<0.01),PVCs组的舒张期径向应变率峰值(Diastolic radial strain rate peak,DRSR)较NSVT组、对照组减低(P<0.05)。左心室整体应变GRS、GSC、GLS与LVEF具有较强的相关性,其中相关性最强的是GRS(r=0.586,P<0.01);左心室应变参数与心律、LVESVI、LVSIV轻度相关(P<0.05)。左心室多项应变参数联合诊断对PVCs与NSVT患者具有较高的鉴别诊断价值(AUC=0.822,敏感度87.2%,特异度75.5%)。结论:CMR-FT技术能够早期发现IVA患者左心室功能障碍,评估疾病进展程�Objective:To explore the value of cardiac magnetic resonance feature tracking(CMR-FT)in the early assessment of left ventricular dysfunction in patients with idiopathic ventricular arrhythmias(IVA).Methods:A total of 106 patients with idiopathic ventricular arrhythmias treated at our hospital from January 2018 to May 2023 were retrospectively included.Based on 24-hour ambulatory electrocardiography,the patients were divided into two groups:the frequent premature ventricular contractions group(PVCs)and the non-sustained ventricular tachycardia group(NSVT).Additionally,40 healthy individuals who underwent cardiac magnetic resonance(CMR)examination during the same period were selected as the control group.Post-processing software was employed to assess conventional left ventricular functional parameters and myocardial strain parameters,including left ventricular ejection fraction(LVEF),left ventricular end diastolic volume index(LVEDVI),left ventricular end systolic volume index(LVESVI),left ventricular myocardial mass index(LVMI),as well as peak strain and peak strain rate parameters in three directions of the left ventricle data analysis was performed by using SPSS 26.0 software.Results:In the PVCs group,the left ventricular end-systolic volume index(LVESVI)was higher compared to both the NSVT and control groups,while LVEF was lower than those of the NSVT group and control group(P<0.05).Global radial strain(GRS),global circumferential strain(GCS),global longitudinal strain(GLS),systolic radial strain rate peak(SRSR),and systolic circumferential strain rate peak(SCSR)in all idiopathic ventricular arrhythmia(IVA)groups were lower than those in the control group(P<0.05).GRS,GCS,GLS,SRSR,and SCSR also exhibited significant differences between the PVCs and NSVT groups(P<0.01),and diastolic radial strain rate peak(DRSR)in the PVCs group was lower than that in the NSVT and control groups(P<0.05).Left ventricular strain parameters demonstrated a strong correlation with LVEF,with GRS showing the highest correlation(r=0.586

关 键 词：室性心律失常 心室功能 左 磁共振成像 特征追踪 

分 类 号：R445.2[医药卫生—影像医学与核医学]