磁共振T1、T2 mapping技术定量评价心肌的初步研究
发布时间：2018-08-03 06:55
【摘要】：目的利用基于改进的Look-Locker快速稳态自由进动饱和恢复(MLLSR)序列的T1mapping技术和基于多回波快速自旋回波(MEFSE)序列的T2 mapping技术定量评价心肌梗死患者和健康志愿者左室心肌:(1)探讨此两种技术临床应用的可行性和可重复性;(2)讨论初始T1值、增强后T1值、细胞外间隙(ECV)和T2值定量评价心肌梗死的诊断价值;(3)评价健康志愿者左室不同区域心肌的初始T1值和T2值以供参考。资料和方法(1)选取符合诊断标准的8例心肌梗死患者行3.0T心脏磁共振Cine电影、T2WI序列、T2 mapping、增强前T1 mapping、首过灌注、造影剂延迟强化和增强后T1mapping序列检查,分别测量心肌梗死区域与远隔正常心肌区域内初始T1值、增强后T1值、ECV值和T2值,并对其进行独立样本t检验、One-way ANOVA方差分析和ROC曲线分析。(2)对符合入组条件的30例健康志愿者,分别行Cine电影、T2WI序列、T1 mapping和T2 mapping序列扫描,测定感兴趣区内初始T1值和T2值,应用独立样本t检验或One-way ANOVA方差分析方法统计分析心肌17节段及不同供血区、年龄和性别有无差别。对所测得的初始T1值和T2值进行Bland-Altman一致性分析和Pearson相关分析。结果(1)心肌梗死区域和远隔正常心肌区域的初始T1值、增强后T1值、ECV值和T2值均有统计学差异(t=3.752、-2.910、5.029和4.137,P0.01),其值如下:初始T1值,(754.8±273.8)ms和(561.4±152.8)ms;增强后T1值,(438.8±73.6)ms和(506.1±120.0)ms;ECV值,(0.334±0.179)ms和(0.158±0.116)ms;T2值,(81.9±15.7)ms和(65.1±10.0)ms。急性心肌梗死区域的初始T1、ECV值和T2值高于亚急性、慢性心肌梗死区域(F=14.210,10.367和12.342,P0.001)。各参数值在定量评价心肌梗死方面具有较高的敏感度、特异度和准确度。(2)健康志愿者左室17节段心肌初始T1值和T2值不全相等(P0.01)。心肌平均初始T1值、血池平均初始T1值和心肌平均T2值如下:基底部,(717.6±100.6)ms,(1208.9±224.2)ms,(71.6±7.1)ms;中间部,(773.9±101.2)ms,(1281.2±251.7)ms,(77.3±9.2)ms;心尖部,(955.4±191.1)ms,(1829.6±584.8)ms,(83.0±8.5)ms。心尖部心肌和血池的初始T1值高于中间部和基底部(P0.01),从基底部到心尖部心肌T2值逐渐升高(F=14.245,P0.01)。左前降支、右冠状动脉及左旋支供血区心肌初始T1值有统计学差异(F=47.862,P0.01)而心肌T2值无统计学差异(F=1.656,P=0.192)。根据Bland-Altman一致性分析和Pearson相关分析得到参数测量在观察者间具有良好的一致性。结论MLLSR T1 mapping和MEFSE T2 mapping技术在心脏成像中具有较好的可行性和可重复性。此两种技术得到的初始T1值、增强后T1值、ECV值和T2值可定量评价心肌梗死,具有较好的临床应用前景。中国健康志愿者中左室心肌初始T1值和T2值存在节段性差异。
[Abstract]:Objective to quantitatively evaluate the left ventricular myocardium of patients with myocardial infarction and healthy volunteers by using improved T1mapping technology based on improved Look-Locker fast steady free dynamic progressive saturation recovery (MLLSR) sequence and T2 mapping based on multiple echo fast spin echo (MEFSE) sequences: (1) to explore the feasibility and repeatability of these two clinical applications. 2) the initial T1 value, the enhanced T1 value, the extracellular space (ECV) and the T2 value were used to evaluate the diagnostic value of myocardial infarction; (3) to evaluate the initial T1 value and T2 value of the myocardium in the left ventricular region of the healthy volunteers for reference. (1) 8 patients with myocardial infarction, which were in accordance with the diagnostic criteria, were performed 3.0T cardiac MRI Cine film, T2WI sequence, T2. Mapping, pre enhanced T1 mapping, first over perfusion, delayed enhancement and enhanced T1mapping sequence examination, the initial T1 values in the myocardial infarction region and the normal myocardial region were measured respectively, the T1 value, the ECV value and the T2 value were enhanced, and the independent sample t test, One-way ANOVA variance analysis and ROC curve analysis were carried out. (2) conforms to the entry group. 30 healthy volunteers were performed Cine film, T2WI sequence, T1 mapping and T2 mapping sequence scanning. The initial T1 value and T2 value in the region of interest were measured. Independent sample t test or One-way ANOVA variance analysis was used to analyze the 17 segments of the myocardium and the different blood supply regions. Bland-Altman consistency analysis and Pearson correlation analysis. Results (1) the initial T1 value of myocardial infarction area and distant normal myocardial region, enhanced T1 value, ECV value and T2 value were statistically different (t=3.752, -2.910,5.029 and 4.137, P0.01), the values were as follows: initial T1 value, (754.8 + 273.8) MS and (561.4 + 152.8) MS; (438.8 +) 73.6) ms and (506.1 + 120) MS; ECV value, (0.334 + 0.179) ms and (0.158 + 0.116) MS; T2 value, (81.9 + 15.7) ms and (65.1 +) Ms. acute myocardial infarction region, initial T1, ECV value and T2 value higher than subacute, chronic myocardial infarction region (F=14.210,10.367 and 12.342,). Degree, specificity and accuracy. (2) the initial T1 value and T2 value of the left ventricular myocardium in the healthy volunteers were not all equal (P0.01). The average initial T1 value of the myocardium, the mean initial T1 value of the blood pool and the average T2 value of the myocardium were as follows: the basal part, (717.6 + 100.6) ms, (1208.9 + 224.2) ms, (71.6 + 7.1) MS; the middle part, (773.9 + 101.2) ms, (1281.2 + 251.7) ms, (77.3 + 9.2) MS; heart (77.3 + 9.2) MS; heart The apex, (955.4 + 191.1) ms, (1829.6 + 584.8) ms, (83 + 8.5) Ms., the initial T1 value of the apical myocardium and blood pool was higher than that in the middle and basal parts (P0.01), and the T2 value increased gradually from the basal part to the apical myocardium (F=14.245, P0.01). The left anterior descending branch, the right coronary artery and the left branch blood supply region had statistical difference (F=47.862, P0.01). The T2 values of muscle were not statistically different (F=1.656, P=0.192). According to Bland-Altman consistency analysis and Pearson correlation analysis, the parameters measured were good consistency among the observers. Conclusion MLLSR T1 mapping and MEFSE T2 mapping technology have good feasibility and repeatability in cardiac imaging. The initial T1 values obtained by these two techniques, The enhanced T1 value, ECV value and T2 value can quantitatively evaluate the myocardial infarction and have a good clinical prospect. There is a segmental difference between the initial T1 and T2 values in the left ventricular myocardium in Chinese healthy volunteers.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R445.2;R542.22
本文编号：2160917
[Abstract]:Objective to quantitatively evaluate the left ventricular myocardium of patients with myocardial infarction and healthy volunteers by using improved T1mapping technology based on improved Look-Locker fast steady free dynamic progressive saturation recovery (MLLSR) sequence and T2 mapping based on multiple echo fast spin echo (MEFSE) sequences: (1) to explore the feasibility and repeatability of these two clinical applications. 2) the initial T1 value, the enhanced T1 value, the extracellular space (ECV) and the T2 value were used to evaluate the diagnostic value of myocardial infarction; (3) to evaluate the initial T1 value and T2 value of the myocardium in the left ventricular region of the healthy volunteers for reference. (1) 8 patients with myocardial infarction, which were in accordance with the diagnostic criteria, were performed 3.0T cardiac MRI Cine film, T2WI sequence, T2. Mapping, pre enhanced T1 mapping, first over perfusion, delayed enhancement and enhanced T1mapping sequence examination, the initial T1 values in the myocardial infarction region and the normal myocardial region were measured respectively, the T1 value, the ECV value and the T2 value were enhanced, and the independent sample t test, One-way ANOVA variance analysis and ROC curve analysis were carried out. (2) conforms to the entry group. 30 healthy volunteers were performed Cine film, T2WI sequence, T1 mapping and T2 mapping sequence scanning. The initial T1 value and T2 value in the region of interest were measured. Independent sample t test or One-way ANOVA variance analysis was used to analyze the 17 segments of the myocardium and the different blood supply regions. Bland-Altman consistency analysis and Pearson correlation analysis. Results (1) the initial T1 value of myocardial infarction area and distant normal myocardial region, enhanced T1 value, ECV value and T2 value were statistically different (t=3.752, -2.910,5.029 and 4.137, P0.01), the values were as follows: initial T1 value, (754.8 + 273.8) MS and (561.4 + 152.8) MS; (438.8 +) 73.6) ms and (506.1 + 120) MS; ECV value, (0.334 + 0.179) ms and (0.158 + 0.116) MS; T2 value, (81.9 + 15.7) ms and (65.1 +) Ms. acute myocardial infarction region, initial T1, ECV value and T2 value higher than subacute, chronic myocardial infarction region (F=14.210,10.367 and 12.342,). Degree, specificity and accuracy. (2) the initial T1 value and T2 value of the left ventricular myocardium in the healthy volunteers were not all equal (P0.01). The average initial T1 value of the myocardium, the mean initial T1 value of the blood pool and the average T2 value of the myocardium were as follows: the basal part, (717.6 + 100.6) ms, (1208.9 + 224.2) ms, (71.6 + 7.1) MS; the middle part, (773.9 + 101.2) ms, (1281.2 + 251.7) ms, (77.3 + 9.2) MS; heart (77.3 + 9.2) MS; heart The apex, (955.4 + 191.1) ms, (1829.6 + 584.8) ms, (83 + 8.5) Ms., the initial T1 value of the apical myocardium and blood pool was higher than that in the middle and basal parts (P0.01), and the T2 value increased gradually from the basal part to the apical myocardium (F=14.245, P0.01). The left anterior descending branch, the right coronary artery and the left branch blood supply region had statistical difference (F=47.862, P0.01). The T2 values of muscle were not statistically different (F=1.656, P=0.192). According to Bland-Altman consistency analysis and Pearson correlation analysis, the parameters measured were good consistency among the observers. Conclusion MLLSR T1 mapping and MEFSE T2 mapping technology have good feasibility and repeatability in cardiac imaging. The initial T1 values obtained by these two techniques, The enhanced T1 value, ECV value and T2 value can quantitatively evaluate the myocardial infarction and have a good clinical prospect. There is a segmental difference between the initial T1 and T2 values in the left ventricular myocardium in Chinese healthy volunteers.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R445.2;R542.22
【共引文献】
相关期刊论文 前1条
1 Yuanbo Feng;Zhan-Long Ma;Feng Chen;Jie Yu;Marlein Miranda Cona;Yi Xie;Yue Li;Yicheng Ni;;Bifunctional staining for ex vivo determination of area at risk in rabbits with reperfused myocardial infarction[J];World Journal of Methodology;2013年03期
相关博士学位论文 前1条
1 于静;能谱CT定量评估猪急性缺血—再灌注型MI[D];天津医科大学;2014年
相关硕士学位论文 前1条
1 王兴兰;定量T_2-mapping在心脏成像中的应用研究进展[D];重庆医科大学;2014年
，本文编号：2160917
本文链接：https://www.wllwen.com/yixuelunwen/xxg/2160917.html
最近更新
教材专著
