摘要
目的探讨心脏磁共振(cardiac magnetic resonance,CMR)内源性对比纵向弛豫时间(T1ρ)成像技术在肥厚型心肌病(hypertrophic cardiomyopathy,HCM)心肌纤维化检测中的可行性。材料与方法前瞻性纳入60例成年HCM患者,以及20例年龄及性别匹配的健康对照者(对照组)。入组对象均进行对比剂注入前后的CMR三层短轴T1 mapping以及位置相匹配的T1ρ成像,根据美国心脏协会心肌分段标准将左心室分成16节段,将心肌分成室壁厚度正常(hypertrophic cardiomyopathy ventricular wall normal thickness,HCM-N)组和室壁肥厚(hypertrophic cardiomyopathy ventricular wall hypertrophy thickness,HCM-H)组。计算各组心肌初始T1值、细胞外容积(extracellular volume fraction,ECV)及T1ρ值,采用单因素方差分析比较对照组、HCM-N组及HCM-H组间的差异,并采用Pearson分析ECV和T1ρ的相关性。结果对照组、HCM-N组和HCM-H组的ECV逐渐增加,分别为(27.4±2.8)%、(31.5±4.8)%和(37.2±7.2)%,组间差异具有统计学意义(F=64.219,P<0.001)。对照组、HCM-N组和HCM-H组的T1ρ值依次增加,分别为(38.4±1.5)ms、(41.6±5.1)ms和(47.4±7.9)ms,差异具有统计学意义(F=81.399,P<0.001)。3组间ECV、T1ρ值的组间两两比较差异均有统计学意义(P<0.001)。对照组、HCM-N组和HCM-H组的初始T1值分别为(1270.1±92.0)ms、(1292.4±127.0)ms、(1338.2±103.3)ms,差异具有统计学意义(F=9.921,P<0.001),初始T1值在对照组与HCM-H组(P<0.001)、HCM-N组与HCM-H组间差异具有统计学意义(P=0.001),在对照组和HCM-N间差异无统计学意义(P=0.054)。ECV与T1ρ的相关性为0.734。结论磁共振内源性对比T1ρ成像能够敏感地识别HCM患者心肌纤维化,具有评估心肌纤维化的潜在临床应用价值。
Objective:To investigate cardiac magnetic resonance(CMR)endogenous longitudinal relaxation time(T1ρ)in the diagnosis of myocardial fibrosis in patients with hypertrophic cardiomyopathy(HCM).Materials and Methods:Sixty adult HCM patients and 20 age and sex matched healthy volunteers were prospectively included.All subjects received T1 mapping and T1ρ.According to whether the ventricular wall segments were hypertrophic,HCM was further divided into HCM ventricular wall normal thickness group(HCM-N)and HCM ventricular wall hypertrophic thickness(HCM-H)group.The initial T1 mapping,ECV and T1ρwere measured.The differences among healthy control group,HCM-N and HCM-H groups were analyzed and compared by one-way ANOVA.The consistency between extracellular volume fraction(ECV)and T1ρwere analyzed by Pearson.In addition,ECV as the reference,the value of T1ρin the detection of myocardial fibrosis in HCM were analyzed.Results:ECV gradually increased from control group to HCM-N group and to HCM-H group[Control(27.4±2.8)%vs.HCM-N(31.5±4.8)%vs.HCM-H(37.2±7.2)%;F=64.219,P<0.001].T1ρmapping has the same trend as ECV[Control(38.4±1.5)ms vs.HCM-N(41.6±5.1)ms vs.HCM-H(47.4±7.9)ms;F=81.399,P<0.001].There were significant differences in ECV,T1ρmapping between control group and HCM-N group,control group and HCM-H group,HCM-N group and HCM-H group(P<0.001).There was significant difference in native T1 among control group,HCM-N group and HCM-H group[Control(1270.1±92.0)ms vs.HCM-N(1292.4±127.0)ms vs.HCM-H(1338.2±103.3)ms;F=9.921,P<0.001].There was no statistical difference in native T1 mapping between HCM-N and control group,but there were significant differences between HCM-N group and HCM-H group,and between HCM-H and control group.The consistency between ECV and T1ρis 0.734.Conclusions:CMR endogenous T1ρcould sensitively identify myocardial fibrosis in HCM patients,,and has potential clinical value in evaluating myocardial fibrosis.
作者
王可颜
郑捷
张勇
黄荟玉
张文博
李舒曼
金红瑞
靳雅楠
程敬亮
WANG Keyan;ZHENG Jie;ZHANG Yong;HUANG Huiyu;ZHANG Wenbo;LI Shuman;JIN Hongrui;JIN Yanan;CHENG Jingliang(Department of MRI,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Mallinckrodt Institute of Radiology,Washington University in St.Louis,St.Louis 63110,USA)
出处
《磁共振成像》
CAS
CSCD
北大核心
2022年第12期51-57,共7页
Chinese Journal of Magnetic Resonance Imaging
