心脏磁共振追踪技术在直背综合征及致心律失常性右心室心肌病中的应用  

Application of cardiac magnetic resonance imaging feature tracking technology in the diagnosis and differentiation of straight back syndrome and arrhythmogenic right ventricular cardiomyopathy

作　　者：谢欢 唐星 黄松涛 王辉[1] XIE Huan;TANG Xing;HUANG Songtao;WANG Hui(Department of Radiology,Beijing Anzhen Hospital,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所医学影像科,100029 [2]广安市人民医院放射科 [3]岳池县中医院放射科

出　　处：《心肺血管病杂志》2025年第1期76-82,共7页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市医院管理中心“青苗”计划专项经费(QML20230610);广安市人民医院高质量发展基金项目(21FZ011)。

摘　　要：目的:应用心脏磁共振(cardiac magnetic resonance,CMR)及其特征追踪技术(feature-tracking cardiac magnetic resonance,FT-CMR)评价直背综合征(straight back syndrome,SBS)及致心律失常性右心室心肌病(arrhythmogenic right ventricular cardiomyopathy,ARVC)患者右心室功能及心肌应变的改变,为两种疾病的诊断及鉴别提供重要依据。方法:回顾性收集首都医科大学附属北京安贞医院,2016年8月至2022年12月接受CMR检查的病例,包括以胸8椎体中部水平胸腔前后径/通过右膈顶最高点胸廓左右横径(antero-posterior diameter/thoracic transverse diameter,APD/TTD)比值<0.33为标准诊断的直背综合征(straight back syndrome,SBS)患者48例(SBS组),以2010年欧洲心脏病协会修订版ARVC诊断标准筛选的ARVC患者31例(ARVC组),以同期心电图、超声、CMR结果阴性的健康对照者45例(对照组)。通过FT-CMR技术测量SBS组、ARVC组、对照组右心室功能及整体心肌应变参数。结果:SBS组右心室射血分数(right ventricular rejection fraction,RVEF)、右心室整体径向峰值应变(global peak radial strain,GRS)、整体周向峰值应变(global peak circumferential strain,GCS)、整体纵向峰值应变(global peak longitudinal strain,GLS)均小于对照组,差异有统计学意义(P<0.05)。根据是否存在心律失常将SBS患者分为心律失常亚组和无心律失常亚组,结果显示:两亚组右心室GRS、GCS、GLS差异均无统计学意义。SBS组APD/TTD比值与RVEF、GRS、GCS、GLS均无相关性。ARVC组右心室舒张末期容积(right ventricular enddiastole volume, RVEDV)、右心室收缩末期容积(right ventricular end-systole volume,RVESV)大于对照组,RVEF、GRS、GCS、GLS均小于对照组,差异有统计学意义(P<0.05)。ARVC组RVEDV、RVESV大于SBS组,RVEF、GRS、GCS、GLS均小于SBS组,差异均有统计学意义(P <0.05)。ARVC组GRS、GCS、GLS均小于SBS组中心律失常亚组,差异有统计学意义(P <0.05)。结论:SBS及ARVC患者RVEF及�Objective:Application of cardiac magnetic resonance(CMR)and feature tracking technology(FT-CMR)to evaluate the changes in right ventricular function and myocardial strain in patients with straight back syndrome(SBS)and arrhythmogenic right ventricular cardiomyopathy(ARVC),for providing important evidence for the diagnosis and differentiation of these two diseases.Methods:A retrospective collection cases that underwent CMR at Beijing Anzhen Hospital affiliated with Capital Medical University from August 2016 to December 2022 was conducted,which included 48 SBS patients diagnosed with an APD/TTD ratio(a ratio between the anteroposterior diameter of the chest in the middle of the thoracic vertebral body and the transverse diameter passing through the highest point of the right septum)less than 0.33(SBS group),31 ARVC patients diagnosed according to the revised ARVC diagnostic criteria published by the European Heart Association in 2010(ARVC group),and 45 healthy controls(control group)with negative results in electrocardiogram,ultrasound,and CMR during the same period.Right ventricular function and global myocardial strain parameters in the SBS,ARVC,and control groups were measured using FT-CMR technology,respectively.Results:The RVEF and the GRS,GCS,GLS of the right ventricle in the SBS group were significantly lower than those in the control group(all P<0.05).Furthermore,SBS patients were divided into the arrhythmia subgroup and the non-arrhythmia subgroup based on the presence of arrhythmia,and the results showed no statistical differences in GRS,GCS,GLS of the right ventricular between the two subgroups.There was no significant correlation between the APD/TTD ratio and RVEF,GRS,GCS,GLS in the SBS group.The RVEDV and RVESV in the ARVC group were higher than those in the control group,while the RVEF,GRS,GCS and GLS were significantly lower than those in the control group(all P<0.05).The GRS,GCS and GLS of the right ventricular in ARVC group were significantly lower than those in the SBS group(all P<0.05).And the G

关 键 词：直背综合征 致心律失常性右心室心肌病 特征追踪技术 磁共振成像 心肌应变 右心室 

分 类 号：R54[医药卫生—心血管疾病]