心脏磁共振定量组织标记技术在急性病毒性心肌炎与特发性炎性肌病中的应用价值  

Application of Cardiac Magnetic Resonance Imaging Quantitative Tissue Label⁃ing Technique in Acute Viral Myocarditis and Idiopathic Inflammatory Myopathy

作　　者：吴琳 蒋晖[1] 徐敏[1] 高靳[1] WU Lin;JIANG Hui;XU Min;GAO Jin(Chengdu Third People′s Hospital,Chengdu 610014,China)

机构地区：[1]成都市第三人民医院,成都610014

出　　处：《岭南心血管病杂志》2025年第1期35-39,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的分析心脏磁共振(cardiac magnetic resonance imaging,CMR)对急性病毒性心肌炎(acute viral myocar⁃ditis,AVM)与特发性炎性肌病(idiopathic inflammatory myopathy,IIM)患者心肌受累的诊断价值。方法对成都市第三人民医院2020年11月至2022年5月期间收治确诊的AVM患者43例、IIM患者48例的临床资料予以分析。观察CMR检查的左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)、左心室收缩末期容积(left ventricular end-systolic volume,LVESV)、左心排血量(left ventricular stroke volume,LVSV)、心脏指数(cardiac index,CI)、左心室心肌质量指数(left ventricular mass index,LVMI)等参数指标。结果AVM组患者CMR延迟钆增强(late gadolinium enhancement,LGE)发生、LGE室间隔、LGE非室间隔、LGE中层为主、NativeT1、细胞外间质容积分数(extracellular volume fraction,ECV)、LVEF、LVEDV、LVESV、CI、LVMI与IIM组比较,差异有统计学意义(P<0.05)。将CMR各检测参数纳入二元Logistic回归中,根据结果的回归系数计算联合数据进行受试者工作特征曲线(receiver operating characteristic curve,ROC)分析显示,其AUC达0.972,诊断敏感度为98.8%、特异度为83.3%、约登指数为0.833。结论CMR检测AVM、IIM患者心肌受累的结果存在差异性,为减少误诊的发生,建议临床结合其他指标予以联合判定,避免单一手段造成局限。Objectives To analyze the value of cardiac magnetic resonance imaging(CMR)in evaluating myocardial involvement of patients with acute viral myocarditis(AVM)and idiopathic inflammatory myopathy(IIM).Methods The clinical data of 43 patients with AVM and 48 patients with IIM diagnosed in Chengdu Third People′s Hospital from November 2020 to May 2022 were analyzed.The indexes and parameters of CMR examination were observed,including left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular stroke volume(LVSV),cardiac index(CI),left ventricular mass index(LVMI).Results The CMR late gadolinium enhancement(LGE)occurrence,LGE interventricular septum,LGE non-ventricular septum,LGE middle layer,NativeT1,extracellular volume fraction(ECV),LVEF,LVEDV,LVESV,CI and LVMI were significantly different between AVM group and IIM group(P<0.05).The parameters of CMR were included in the binary Logistic regression,and the receiver operating characteristic curve(ROC)analysis of the joint data was carried out according to the regression coefficient of the results.The results showed that the area under the curve(AUC)was 0.972,the diagnostic sensitivity was 98.8%,the specificity was 83.3%,and the Jordan index was 0.833.Conclusions There are differences between AVM and IIM in CMR detection results,In order to reduce the occurrence of misdiagnosis,it is suggested that other indicators should be combined to determine to avoid the limitations caused by a single method.

关 键 词：心脏磁共振 急性病毒性心肌炎 特发性炎性肌病 心肌受累 

分 类 号：R540.4[医药卫生—心血管疾病]