MRI评估扩张型心肌病患者左心室收缩和心肌纤维化的价值分析

Value of MRI in the Evaluat ion of Left Ventricular Systolic Function and Myocardial Fibrosis in Patients with Dilated Cardiomyopathy

目的研究MRI在评估扩张型心肌病(DCM)患者左心室收缩和心肌纤维化中的应用价值。方法选取2016年10月至2018年10月我院DCM患者53例及同期健康体检者50例分别为研究组和对照组并进行心脏磁共振(CMR)和磁共振纵向弛豫时间定量(T1 mapping)成像检查,比较两组左室舒张末期室壁厚度(TDD)、左室收缩末期室壁厚度(TSD)、室间隔基底段厚度(IVS)及左室心肌质量(LVMM)等结构参数以及左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室每搏输出量(LVSV)及左室射血分数(LVEF)等功能参数及心肌T1值并采用Pearson系数进行相关性分析。结果研究组TDD和TSD低于对照组,LVMM高于对照组;研究组LVEDV、LVESV及心肌T1值高于对照组,LVSV及LVEF低于对照组,差异有统计学意义(P<0.05);Pearson相关性分析结果显示心肌T1值与TDD、TSD、LVSV及LVEF呈负相关性,与LVEDV和LVESV呈正相关性,差异均有统计学意义(P<0.05)。结论CMR技术可准确测量D C M患者心脏结构和功能参数,直接判断患者心功能状态,T1 mapping可有效反映心肌弥漫性纤维化程度,对DCM临床诊断、病情评估和预后判断均具有重要价值。

Objective To study the application value of MRI in the evaluation of left ventricular systolic function and myocardial fibrosis in patients with dilated cardiomyopathy(DCM).Methods 53 patients with DCM in our hospital from October 2016 to October 2018 and 50 subjects at the same period for physical examination were selected as study group and control group respectively,and they were given cardiac magnetic resonance(CMR)and magnetic resonance longitudinal relaxation time were quantified imaging examination(T1 mapping).The structural parameters of left ventricular end-diastolic wall thickness(TDD),left ventricular end-systolic wall thickness(TSD),interventricular septal thickness(IVS)and left ventricular myocardial mass(LVMM),and functional parameters of left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular stroke volume(LVSV)and left ventricular ejection fraction(LVEF),and myocardial T1 value were compared between the two groups,and correlation analysis was made by Pearson coefficient.Results The TDD and TSD in study group were lower than those in control group while the LVMM was higher than that in control group.The LVEDV,LVESV and myocardial T1 value in study group were higher than those in control group while the LVSV and LVEF were lower than those in control group(P<0.05).Pearson correlation analysis showed that myocardial T1 value was negatively correlated with TDD,TSD,LVSV and LVEF,and was positively correlated with LVEDV and LVESV(P<0.05).Conclusion CMR can accurately measure the cardiac structure and functional parameters of patients with DCM,and directly judge the cardiac function status T1 mapping can effectively reflect the degree of myocardial diffuse fibrosis,and it is of great value for clinical diagnosis,disease assessment and prognosis of DCM.