摘要
目的探讨对比增强MR纵向弛豫时间定量成像（T1mapping）技术评价心肌病弥漫性心肌纤维化的价值，以及心肌纤维化与心功能的关系。方法回顾性搜集2013年9月至2014年9月，经临床及影像诊断证实的76例心肌病（包含心肌炎）患者（心肌病组）和33名对照组入选本研究。所有入选对象均行心脏MR检查，扫描序列包括心脏电影成像、对比增强前后T1mapping成像、延迟强化（LGE）成像，分别计算增强前后左心室平均T1值及心功能参数，利用独立样本t检验比较心肌病组和对照组左心室T1均值。并根据LGE结果将患者分为LGE阳性组和LGE阴性组，对不同入选对象增强前后左心室平均T1值和心功能参数进行单因素方差分析比较，采用Pearson相关分析心肌平均T，值与心功能指标的关系。结果76例心肌病患者中，51例存在延迟强化，25例未见延迟强化。增强前心肌病组T。值为（1306．4±84．6）ms，明显高于对照组[（1266．6±57．3）ms]，差异具有统计学意义（t=2．10，P〈0．01），增强后心肌病组左心室心肌T。值为（483．6±112．0）ms，明显低于对照组[（534．1±92．7）ms]，差异具有统计学意义（t=-0．27，P〈0．05）。其中，LGE阳性组患者增强前后T1值分别为（1322．2±85．8）和（459．7±132．2）ms，LGE阴性组患者增强前后T1值分别为（1267．0±68．5）ms和（521．0±95．2）ms，两组间差异具有统计学意义（P值均〈0．01），但LGE阴性组患者与对照组之间增强前后T1差异均无统计学意义（P值均〉0．05）。心肌病患者增强前后左室心肌T1值与EF值均呈负相关（r值分别为-0．252、-0．217，P值均〈0．01），但与其他心功能参数无明显相关（P值均〉0．05）。结论左心室心肌增强前后T1值有助于心肌病患者弥漫性心肌纤维化的诊断，存在心肌延迟强化的患者T1值变化更明显，且心肌病患者心肌纤维化程度与心脏射血分数呈负相关。
Objective To investigate the value of contrast enhancement T1 mapping in detection of diffuse myocardial fibrosis in cardiomyopathy, and the relationship between myocardial fibrosis and cardiac function. Methods From September 2013 to September 2014, 76 cases of cardiomyopathy patients （including myocarditis） and 33 cases of healthy controls were enrolled in our study. All the subjects underwent cardiac MR （CMR） examination. Scan sequences included cine MR, pre-contrast and post-contrast T1 mapping and late gadolinium enhancement （LGE） imaging. The pre-/post-contrast left ventricle average T1 value and cardiac function of patients and controls were measured and compared by using independent-samples t test. According to the LGE imaging, all the subjects were subsequently divided into LGE positive group, LGE negative group and control group. The myocardial average TI value and cardiac function among the three sub-groups were compared by using one-way ANOVA, and the relationship among them were analyzed by using Pearson correlation. Results Among the 76 cases of non-ischemia cardiomyopathy patients, 51 cases （67.1%） had LGE. Compared with controls, cardiomyopathy patients presented with higher pre-contrast T, value [（1 306.4±84.6）ms vs. （1 266.6±57.3）ms, t=2.10, P〈0.05] and lower post-contrast T1 value [（483.6±112.0）ms vs. （534.1±92.7）ms, t=-0.27, P〈0.05]. Pre-contrast and post-contrast average T1 value of LGE positive patients were （1 322.2±85.8） and （459.7±132.2）ms respectively; pre-eontrast and post-contrast average T1 value of LGE negative patients were （1 267.0±68.5） ms and （521.0±95.2）ms, there were statistical significant differences of T1 value between LGE positive and LGE negative patients （P〈0.01）, however, there were no statistical significant differences of T1 value between LGE negative patients and controls （P〉0.05）. There were correlation between pre-/post-eontrast left ventricle T1 value and ejection fraction （EF） in eardiomyopathy patients （r=-0.252, - 0.217, P〈0.01）, however no statistical correlation with other cardiac function parameters （P〉0.05）. Conclusions The average pre-/post-contrast T1 value in left ventricle myocardium are helpful for detection of diffuse fibrosis in cardiomyopathy patients. The LGE positive is a sign that can greatly change the T1 value of the myocardial tissue, meanwhile, myocardial fibrosis is negative correlated with ejection fraction in eardiomyopathy patients.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2016年第1期13-17,共5页
Chinese Journal of Radiology
基金
国家自然科学基金（81101173）
关键词
心肌疾病
磁共振成像
心内膜心肌纤维化症
Cardiomyopathies
Magnetic resonance imaging
Endomvocardial fibrosis
