基于CMR-FT的应变技术评估心肌淀粉样变患者左心室应变特征  

Quantitative Analysis of Left Ventricular Myocardial Strain in Cardiac Amyloidosis by CMR-FT Technique

作　　者：游弋 苏春艳 杨智[1] 付兵[1] YOU Yi;SU Chun-yan;YANG Zhi;FU Bing(Department of Radiology,Chengdu Fifth People's Hospital,Chengdu 611130,Sichuan Province,China)

机构地区：[1]成都市第五人民医院放射科,四川成都611130

出　　处：《中国CT和MRI杂志》2025年第4期101-104,共4页Chinese Journal of CT and MRI

基　　金：四川省卫健委资助项目(20PJ216);成都市科技局资助项目(2019-YF05-00111-SN)。

摘　　要：目的探究基于CMR-FT的应变技术在评估CA患者心肌功能及受累情况中的价值。方法对33例心肌淀粉样变患者(CA组)、30例肥心病患者(HCM组)及30名健康志愿者(对照组)行3.0 T心脏磁共振检查,采用CMR-FT技术测得左心室整体及各节段3D径向应变(RS)、周向应变(CS)、纵向变(LS)值及相应的峰值收缩期应变率(PSSR)、峰值舒展期应变率(PDSR),分析各参数的组间差异。以LVEF是否大于50%将CA组分为LVEF正常组及减低组,分析LVEF正常组与对照组应变参数的差异。将CA组心功能参数分别与应变参数进行相关性分析。结果三组间整体及各节段CS、RS、LS均为CA组低于其余两组(P<0.05);除心尖部PSSR-C外,其余各节段及各方向PSSR及PDSR为CA低于对照组(P<0.05);CA亚组(LVEF正常组)相较于对照组,除中间部CS值外,整体及各节段CS、RS、LS均有不同程度减低,大部分PDSR及部分PSSR不同程度减低(P<0.05)。CA组各应变参数与LVEDV(r=0.38~0.61,P<0.05)、与LVESV(r=0.42~0.71,P<0.05)具有负相关;CA组各应变参数与LVEF具有正相关(r=0.35~0.84,P<0.05);CA组整体及各节段CS与LS、CS与RS及LS与RS均具有正相关(r=0.53~0.72,P<0.05)。结论以CMR-FT为基础的应变技术可以定量评价CA患者的左心室整体及局部心肌应变特征,并能比LVEF检测出更早期的心肌损伤。Objective This study aimed to explore the value of the CMR-FT in assessing myocardial function and involvement in patients with cardiac amyloidosis(CA).Methods A total of 33 patients with CA,30 patients with HCM and 30 healthy subjects underwent Cardiac magnetic resonance scan using a 3.0T machine.The CMR-FT technique was employed to quantify 3D radial strain(RS),circumferential strain(CS),longitudinal strain(LS),peak diastolic strain rate(PDSR)and peak systolic strain rate(PSSR)of global left ventricular and within each myocardial segment(basal.middle and apical),the differences in these parameters among the three groups were analyzed.The CA group was further divided into subgroups based on LVEF–a normal LVEF group and a reduced LVEF group,depending on whether LVEF was higher than 50%.The differences of strain parameters between normal LVEF group and control group were analyzed.The correlation between cardiac function parameters and strain parameters in CA group was analyzed.Results Patients with CA exhibited significantly reduced RS,CS,and LS in comparison to patients with HCM and healthy subjects(P<0.05).PSSR and PDSR in all segments in CA group were decreased when compared to the control group(P<0.05).The CS,RS,and LS of the global left ventricle and all segments,except for middle CS,in the CA subgroup with normal LVEF were reduced in comparison to the control group.Most PDSR,and some PSS R,were also reduced when compared to the control group.The strain parameters in the CA group demonstrated a negative correlation with LVEDV(r=0.38~0.61,P<0.05)and LVESV(r=0.42~0.71,P<0.05),The strain parameters in the CA group were positively correlated with LVEF(r=0.35~0.84,P<0.05).Positive correlations were also noted between CS and LS,CS and RS,and LS and RS in the global and each segment of the CA group(r=0.53~0.72,P<0.05).Conclusion CMR-FT can be employed to quantitatively assess left ventricular myocardial strain in patients with CA and has the potential to detect myocardial injury at an earlier stage than traditiona

关 键 词：心肌病 心肌淀粉样变 特征追踪 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]