MR特征追踪技术定量评估肥厚型心肌病心肌应变

发布时间：2018-03-25 21:14

本文选题：心肌病　切入点：肥厚型　出处：《中国医学影像技术》2017年08期

【摘要】：目的探讨MR特征追踪技术(CMR-FT)定量分析肥厚型心肌病(HCM)左心室整体和局部心肌应变的临床价值。方法收集HCM患者60例(HCM组)及健康志愿者10名(对照组)。所有受检者均接受心脏MR检查,扫描序列包括心室短轴、二腔心、四腔心层面快速平衡稳态进动序列(FIESTA)和延迟增强扫描(LGE)。HCM组按有无强化分为无强化亚组和有强化亚组。采用CMR-FT后处理软件测定心肌整体的径向应变峰值(GPSR)、环向应变峰值(GPSC)、纵向应变峰值(GPSL)以及心室不同部位(心尖部、心室中部和基底部)的径向、环向和纵向应变峰值(PSR、PSC和PSL)。结果有强化亚组、无强化亚组和对照组的GPSR、GPSC和GPSL差异有统计学意义(P均0.05),呈增高趋势。除心尖部PSL 3组间差异无统计学意义外,有强化亚组、无强化亚组和对照组的PSR、PSC和PSL差异均有统计学意义(P均0.05),在心脏各部位均呈上升趋势。LVEF、SV与GPSR、GPSC、GPSL均呈正相关(P均0.05)。GPSR、GPSC、GPSL诊断HCM的ROC曲线下面积分别为0.79、0.82、0.77(P均0.05),其中GPSC的曲线下面积最大。结论 CMR-FT技术能够早期敏感地发现HCM的心肌应变功能障碍,且纵向应变受损早于或重于环向应变及径向应变。
[Abstract]:Objective to investigate the clinical value of quantitative analysis of left ventricular global and local myocardial strain in patients with hypertrophic cardiomyopathy (HCM) by Mr characteristic tracing technique and CMR-FT.The methods 60 patients with HCM and 10 healthy volunteers (control group) were collected. All patients underwent cardiac Mr examination. The scanning sequence includes the short axis of the ventricle, the two-chamber heart, FIESTAA and LGE.HCM groups were divided into non-enhancement subgroup and enhanced subgroup according to enhancement or not. The peak value of radial strain and circumferential strain were measured by CMR-FT post-processing software. The peak value is GPSC, the longitudinal strain peak is GPSLs, and the different parts of the ventricle (apical region, apical part), The peak values of radial, circumferential and longitudinal strain in the middle of the ventricle and at the base of the ventricle are PSR-PSC and PSL.Results there are enhanced subgroups. There were significant differences in GPSC and GPSL between the non-enhancement subgroup and the control group (P 0.05). There were significant differences in PSRS, PSC and PSL between the non-enhancement subgroup and the control group (P < 0.05), and there was a rising trend in the heart. The area under the ROC curve of the HCM diagnosed by GPSL was 0.790.82 and 0.77 P, respectively, and the area under the ROC curve of GPSL was 0.790.82 and 0.77, respectively, and the area under the ROC curve of GPSL was 0.05 and 0.77, respectively, and the area under the ROC curve of GPSL in the diagnosis of HCM was 0.790.82 and 0.77, respectively, and the area under the ROC curve of GPSL was 0.05g / L, respectively. Conclusion CMR-FT can sensitively detect myocardial strain dysfunction of HCM in early stage. The damage of longitudinal strain is earlier than that of circumferential strain and radial strain.
【作者单位】：南昌大学第二附属医院影像中心MRI室;
【基金】：国家自然科学基金(81660284、81360216) 江西省自然科学基金(20161ACB20013、20142BAB205061)
【分类号】：R445.2;R542.2

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