基于心脏磁共振特征追踪技术的左心室心肌应变评估免疫检查点抑制剂相关心肌炎的可行性  

The Feasibility of Left Ventricular Myocardial Strain Parameters Derived from Cardiac Magnetic Resonance Feature Tracking(CMR-FT)Technique in Evaluating Immune Checkpoint Inhibitor Associated Myocarditis Patients

作　　者：全硕 刘佳[1] 赵凯[1] 李玮[1] 朱燕[2] 贺鹏康[3] 连健秀 邱建星[1] QUAN Shuo;LIU Jia;ZHAO Kai;LI Wei;ZHU Yan;HE Pengkang;LIAN Jianxiu;QIU Jianxing(Department of Radiology,Peking University First Hospital,Beijing 100034,China;Department of Oncology,Peking University First Hospital;Department of Cardiovascular,PekingUniversity First Hospital;School of Biological Science and Medical Engineering,Beihang University)

机构地区：[1]北京大学第一医院医学影像科,北京市100034 [2]北京大学第一医院肿瘤内科 [3]北京大学第一医院心血管内科 [4]北京航空航天大学生物与医学工程学院

出　　处：《中国医学计算机成像杂志》2024年第6期664-669,共6页Chinese Computed Medical Imaging

基　　金：院内交叉临床专项(2022CR32)。

摘　　要：目的:探讨基于心脏磁共振特征追踪(CMR-FT)技术的左心室心肌应变评估免疫检查点抑制剂(ICI)相关心肌炎的可行性。方法:对26例ICI相关心肌炎患者和26例健康受试者进行CMR检查,通过CVI42软件测量左心室的基底段(_(Basal))、中间段(_(Mid))、心尖段(_(Apical))和整体(_(Global))心肌的纵向应变(LS)、周向应变(CS)和径向应变(RS)。采用SPSS 26.0软件对2组左心室心肌应变参数的差异进行统计分析,同时进行受试者工作特征(ROC)曲线分析,以评估所有心肌应变参数的临床诊断效能。结果:ICI相关心肌炎组LS_(Mid)、LS_(Apical)、LS_(Global)、CS_(Basal)、CS_(Mid)、CS_(Apical)、CS_(Global)与对照组比较,差异有统计学意义(P<0.05);ROC曲线分析显示,LS_(Mid)、LS_(Apical)、LS_(Global)、CS_(Mid)、CS_(Apical)、CS_(Global)可用于诊断ICI相关心肌炎,LS_(Global)的诊断效能最高,ROC曲线下面积(AUC)为0.754(截断值=-14.22%,灵敏度=0.692,特异度=0.769)。结论:CMR-FT技术用于左心室的心肌应变,对于诊断ICI相关心肌炎存在临床价值。Purpose:To explore the feasibility of cardiac magnetic resonance feature tracking(CMR-FT)technique in quantitative assessment of left ventricular myocardial strain in patients with immune checkpoint inhibitor(ICI)associated myocarditis.Methods:A total of 52 subjects(26 patients with ICI associated myocarditis and 26 healthy controls)were included in this study.CMR-FT technique was used to measure basal,mid,apical and global myocardium longitudinal strain(LS),circumferential strain(CS)and radial strain(RS)of left ventricle with CVI42.The SPSS 26.0 software was used to test the differences between the two groups'myocardial strain parameters,while the receiver operating characteristic(ROC)curve analysis was performed to evaluate the clinical diagnostic efficacy of all myocardial strain parameters.Results:LSMid,LS_(Apical),LS_(Global),CS_(Global),CSBasal,CSMid,CSApical were significantly changed in the ICI associated myocarditis group compared with the controls(all P<0.05).ROC curve analysis showed that LS_(Mid),LS_(Apical),LS_(Global),CS_(Mid),CS_(Apical)and CS_(Global)could be used for diagnosis of ICI associated myocarditis,while LS_(Global)showed the best performance,the area under ROC curve(AUC)was 0.754(cutoff value=-14.22%,sensitivity=0.692,specificity=0.769).Conclusion:Left ventricular myocardial strain parameters derived from CMR-FT had the potential for early detection of left ventricular dysfunction in ICI associated myocarditis patients.

关 键 词：心脏磁共振 特征追踪 心肌应变 免疫检查点抑制剂相关心肌炎 

分 类 号：R814.4[医药卫生—影像医学与核医学]