心房颤动患者左心室心肌纤维化的MR定量分析研究

发布时间：2018-04-01 14:31

本文选题：磁共振成像　切入点：纵向弛豫时间定量成像　出处：《中国医学影像技术》2017年08期

【摘要】：目的采用MR纵向弛豫时间(T1mapping)定量评估心房颤动(房颤)患者左心室心肌纤维化情况。方法连续入组60例房颤患者(持续性房颤30例、阵发性房颤30例)和59名正常对照,均接受心脏MR检查,分别行心脏电影成像和延迟增强成像,并采用运动自动矫正反转恢复真实稳态自由进动序列进行T1mapping成像。测量左心室心肌增强前T1值并计算细胞外容积(ECV),并与正常对照比较。结果所有患者均完成心脏MR检查,未见心肌延迟强化。正常对照左心室增强前心肌T1值小于阵发性房颤患者及持续性房颤患者,且持续性房颤患者左心室增强前心肌T1值高于阵发性房颤患者(P均0.05)。正常对照左心室心肌ECV与阵发性房颤患者差异无统计学意义(P0.05),而小于持续性房颤患者(P0.05),持续性房颤患者左心室心肌ECV大于阵发性房颤患者(P0.05)。房颤患者心功能各项指标与左心室增强前心肌T1值、ECV均呈正相关(P均0.05)。结论房颤患者存在左心室心肌纤维化,且持续性房颤患者较阵发性房颤患者更严重。
[Abstract]:Objective to quantitatively evaluate left ventricular myocardial fibrosis in patients with atrial fibrillation (AF) by Mr longitudinal relaxation time and T 1 mapping.Methods Sixty consecutive patients with atrial fibrillation (30 patients with persistent atrial fibrillation and 30 patients with paroxysmal atrial fibrillation) and 59 normal controls received cardiac Mr examination.The true steady-state free precession sequence is restored by automatic motion correction inversion and T1mapping imaging is performed.The T 1 value of left ventricular myocardium before enhancement was measured and the extracellular volume (ECV) was calculated and compared with that of normal controls.Results all patients completed Mr examination without delayed enhancement of myocardium.The T 1 value of left ventricular enhanced myocardium in normal control group was lower than that in paroxysmal atrial fibrillation patients and persistent atrial fibrillation patients, and the T 1 value before left ventricular enhancement in patients with persistent atrial fibrillation was higher than that in paroxysmal atrial fibrillation patients (P < 0.05).There was no significant difference between left ventricular myocardial ECV and paroxysmal atrial fibrillation in normal controls, but it was smaller than that in patients with persistent atrial fibrillation. The ECV of left ventricular myocardium in patients with persistent atrial fibrillation was greater than that in patients with paroxysmal atrial fibrillation.The indexes of cardiac function in patients with atrial fibrillation were positively correlated with myocardial T _ 1 value and ECV before left ventricular enhancement (P < 0.05).Conclusion left ventricular myocardial fibrosis exists in patients with atrial fibrillation and is more serious in patients with persistent atrial fibrillation than in patients with paroxysmal atrial fibrillation.
【作者单位】：首都医科大学附属北京安贞医院医学影像科;首都医科大学附属北京安贞医院心内科;北方医院放射科;
【基金】：国家自然科学基金(81101173、81671647) 北京市卫生系统高层次卫生人才培养计划(2013-3-005) 首都卫生发展科研专项基金(首发2016-4-2063) 北京市优秀人才培养资助(2015000021469G196)
【分类号】：R445.2;R541.75;R542.2

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