心脏磁共振组织追踪技术定量评估心肌淀粉样变性左室心肌应变

Cardiac MR Tissue Tracking for Quantitative Assessment of Left Ventricular Myocardial Strain in Cardiac Amyloidosis

目的探讨应用心脏磁共振组织追踪技术(CMR-TT)定量评估心肌淀粉样变性(CA)患者左室心肌应变的价值。方法对29例CA患者(CA组)及32名正常者(对照组)行3.0 T CMR检查,将电影序列导入CMR后处理软件CVI42,得到基本心功能参数及左室整体及各段(心尖、中间及基底段)的平均3D纵向应变峰值(LS)、周向应变峰值(CS)、径向应变峰值(RS),对这些参数进行比较分析,并将总体应变参数与左室射血分数(LVEF)进行相关性分析,最后根据LVEF将CA患者分为LVEF≥50%及<50%两组后分析其差异,并同对照组进行比较。结果CA组的整体及各段的RS、CS、LS均低于对照组(P均<0.05);且CA组左室整体RS、CS、LS与LVEF均有相关性(r=0.605、0.683、0.423,P均<0.05);LVEF≥50%及<50%CA组的整体RS、CS、LS均低于对照组。结论CMR-TT技术能够定量评估CA患者的左室心肌形变特征,其应变参数能够较LVEF更敏感地检测到心肌功能受损。

Objective to evaluate the value of CMR tissue tracking(CMR-TT)in quantitation of myocardium deformation in patients with cardiac amyloidosis(CA).Methods A total of 29 subjects with CA(CA group)and 32 healthy subjects(control group)underwent 3.0 t cardiac magnetic resonance CMR scanning.The cine sequence was imported into CVI 42 post-processing software for cardiac function and strain analysis.Cardiac function and left ventricular 3 D radial strain(RS),circumferential strain(CS),longitudinal strain(LS)were measured.Then the correlation between the Global strain parameters and left ventricular ejection fraction(LVEF)were analyzed.Then CA patients were divided into CA group with LVEF≥50%and CA group with LVEF<50%.They were compared with the control group.Results The global,average basal,mid-LV and apical segmental RS,CS and LS were significantly lower than those in the control group(all P<0.05).In addition,the GRS,GCS and GLS of CA group were correlated with LVEF(r=0.605,0.683,0.423,all P<0.05).GRS,GCS and GLS of CA group with>50%LVEF and the CA group with LVEF<50%were lower than those of the control group(all P<0.05).Conclusion CMR-TT is conducive to quantitatively evaluate myocardial deformation in patients with CA,and myocardial strain parameters permits earlier detection of LV functional impairment than LVEF.