扩张型心肌病MRI特征及诊断价值分析  

Features and Diagnostic Value of MRI in Patients with Dilated Cardiomyopathy

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作  者:王萍萍 尹德超 黄慧 Wang Ping-ping;Yin De-chao;Huang Hui(Department of Nuclear Magnetic Resonance,Zibo First Hospital,Zibo 255200,Shandong Province,China;Department of Joint Orthopedics,Zibo First Hospital,Zibo 255200,Shandong Province,China;Department of Emergency,Zibo First Hospital,Zibo 255200,Shandong Province,China)

机构地区:[1]淄博市第一医院核磁共振科,山东淄博255200 [2]淄博市第一医院关节骨科,山东淄博255200 [3]淄博市第一医院急诊科,山东淄博255200

出  处:《中国CT和MRI杂志》2025年第3期97-100,共4页Chinese Journal of CT and MRI

基  金:山东省医药卫生科技发展计划项目(202203060185)。

摘  要:目的分析扩张型心肌病患者MRI特征及诊断价值。方法选取2022年5月至2024年5月淄博市第一医院核磁共振科收治的100例DCM患者(DCM组)及同期健康体检者36名(对照组)为研究对象,均行MRI检查,分析DCM的MRI影像学特征,对比两组的MRI下左心室结构与功能参数、T1 mapping值,分析各参数与心功能分级的相关性及对于DCM的诊断价值。结果DCM患者的MRI影像学特征主要包括弧形延迟强化、左室扩大、壁运动异常、心肌纤维化、心肌水肿;DCM组左室舒张末期室壁厚度(TDD)、左室收缩末期室壁厚度(TSD)、左室射血分数(LVEF)、左室每搏输出量(LVSV)、增强后T1值均小于对照组(P<0.05),而左室内径(LVDD)、左室心肌质量(LVMM)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、增强前T1值、细胞外容积(ECV)大于对照组(P<0.05),两组室间隔基底段厚度(IVS)差异无统计学意义(P>0.05);DCM组心功能分级Ⅲ~Ⅳ级患者TSD、LVEF、增强后T1值低于Ⅰ~Ⅱ级患者,而LVEDV、LVESV、ECV较Ⅰ~Ⅱ级患者增加(P<0.05);相关分析发现,DCM患者TSD、LVEF、增强后T1值与心功能分级呈负相关,而LVEDV、LVESV、ECV与心功能分级呈正相关(P<0.05);ROC显示,TSD、LVEF、增强后T1值、LVEDV、LVESV、ECV对DCM有较好的诊断价值,曲线下面积分别为0.768、0.804、0.764、0.775、0.652、0.737。结论DCM患者有一定的MRI影像学特征,且MRI可用于判断患者的心功能分级,有较高诊断价值。Objective To analyze the features and diagnostic value of MRI in patients with DCM.Methods A total of 100 patients with DCM(DCM group)admitted to MRI Department of Zibo No.1 Hospital from May 2022 to May 2024 and 36 healthy individuals(control group)were selected as the study subjects.All subjects received MRI examinations,and MRI features of DCM were analyzed.MRI parameters of left ventricular structure and function,and T1 mapping values were compared between the two groups.The correlation between each parameter and cardiac function grading,and the diagnostic value of these parameters for DCM were analyzed.Results MRI features of patients with DCM mainly included arched delayed enhancement,left ventricular enlargement,abnormal wall motion,myocardial fibrosis,and myocardial edema.Left ventricular TDD,left ventricular TS D,LVEF,LVSV and post-enhancement T1 value in the DCM group were smaller than those in the control group(P<0.05).LVDD,LVMM,LVEDV,LVESV,pre-enhancement T1 value and ECV were greater than those in the control group(P<0.05).There was no statistically significant difference in IVS between the two groups(P>0.05).In the DCM group,TS D,LVEF and post-enhancement T1 values of patients with grade III-IV cardiac function were smaller than those of patients with grade I-II cardiac function.LVEDV,LVESV and ECV were greater than patients with grade I-II cardiac function(P<0.05).Correlation analysis found that TS D,LVEF and post-enhancement T1 value were negatively correlated with cardiac function grading,while LVEDV,LVESV and ECV were positively correlated with cardiac function grading in patients with DCM(P<0.05).ROC curves indicated that TS D,LVEF,post-enhancement T1 value,LVEDV,LVESV,and ECV all had good diagnostic value for DCM.The areas under the curves were 0.768,0.804,0.764,0.775,0.652,and 0.737,respectively.Conclusion Patients with DCM have certain MRI features,and MRI can be used to determine the grade of cardiac function.It has high diagnostic value.

关 键 词:扩张型心肌病 MRI 特征 诊断价值 

分 类 号:R542.2[医药卫生—心血管疾病]

 

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