T2 mapping在心肌梗死后心肌水肿检测中的应用以及与血清肌酸激酶间的相关性分析

Application of T2 mapping in assessment of myocardial edema after infarction and analysis of the correlation between T2 mapping and serum creatine kinase

目的探讨定量T2 mapping在心肌梗死后心肌水肿评估中的应用价值,并对T2值、心肌水肿面积及生化指标肌酸激酶峰值进行相关性分析。方法回顾性分析心肌梗死再灌注治疗后患者共30例,并于患者冠状动脉介入治疗(PCI)术后2～7 d内对其进行心脏磁共振扫描(CMR)。图像采集完成后,测算并记录心肌梗死后水肿区域及远侧正常心肌的T2值与水肿面积,最后对梗死后水肿区域和远侧心肌T2值进行比较。并将患者血清肌酸激酶与T2 mapping中所测算的T2值及水肿面积分别进行相关性分析。结果 1心肌梗死后水肿区域T2信号显著高于远侧正常心肌,T2值分别为(59.18±4.23)ms及(43.35±2.11)ms(P=0.013)。2通过T2 mapping测算所得的心肌水肿区域面积与血清肌酸激酶峰值指标呈正相关(r=0.82,P=0.000)。3水肿区域T2值与血清肌酸激酶峰值间相关性欠佳(r=0.475,P=0.054)。结论定量T2 mapping在急性心肌梗死后心肌水肿的评估中非常有价值,而急性心肌梗死后的心肌水肿面积对心肌损伤评估可能更为重要。

Objective To explore the application of quantitative T2 mapping for assessing the myocardial edema after myocardial infarction （MI） and analyze the correlation between T2 value, area of myocardial edema, and the peak value of biochemical index creatine kinase （ CK）. Methods Thirty patients with MI who underwent reperfusion therapy were retrospectively analyzed. Patients received cardiac magnetic resonance imaging （CMR） within 2 - 7 d after percutaneous coronary intervention （ PCI）. T2 values of edema region and distal normal myocardium and the area of edema were calculated and documented after images were collected. T2 values of edema region and distal normal myocardium were compared. The correlation of T2 values and the area of edema calculated via T2 mapping with serum CK was analyzed. Results ①T2 value [ （59.18 ± 4.23） ms] of edema region was significantly higher than that of distal normal myocardium [（43.35 ± 2.11） ms] （P= 0. 013）. ②The area of edema region calculated via T2 mapping was positively correlated to the peak value of serum CK （r=0.82, P=0. 000）. ③T2 value of edema region was not correlated to the peak value of serum CK （r = 0. 475, P = 0. 054）. Conclusion Quantitative T2 mapping is valuable for the assessment ofmyocardial edema in acute MI. The area of myocardial edema may be more important for the assessment of myocardial injury after acute MI.