1.5T磁共振T1mapping技术评价扩张型心肌病弥漫性纤维化的研究

The evaluation of diffuse myocardial fibrosis of dilated cardiomyopathy with T1 mapping methods using 1.5T MRI

目的:探讨1.5T磁共振T1mapping技术评价扩张型心肌病患者弥漫性心肌纤维化的能力。方法:对我院63例扩张型心肌病患者和15位健康志愿者进行回顾性分析。将DCM患者分为两亚组:LGE(-)组为未发现明显延迟强化患者组,LGE(+)组为至少发现一处延迟患者组。比较分析各组的平扫T1值,细胞外容积分数(ECV)值和心功能参数。结果:DCM患者及LGE(+)、LGE(-)两组的左心平扫T1值和ECV值较对照组均升高,且LGE(+)、LGE(-)两组间并无明显统计学差异。单独比较LGE(+)、LGE(-)两组无明显延迟强化节段发现,LGE(-)组无明显延迟强化节段ECV值(31.2±2.3)%高于LGE(+)组(29.8±2.2)%,两者有明显统计学差异(P<0.01)。DCM组左心ECV值与左心射血分数呈负相关,r=-0.47,P<0.01。结论:磁共振T1mapping技术可以很好地评价扩张型心肌病患者的弥漫性心肌纤维化,尤其是对于未发现明显延迟强化的患者。

Objective:To evaluate the ability of 1.5 T magnetic resonance T1 mapping technique to evaluate diffuse myocardial fibrosis in patients with dilated cardiomyopathy.Method:A retrospective analysis of 63 patients with dilated cardiomyopathy and 15 healthy volunteers in our hospital.DCM patients were divided into two groups:patients with no obvious delay enhancement were divided in group LGE(-),and with at least one delay enhancement in group LGE(+).Pre-T1 values,extracellular volume fraction(ECV)values and cardiac function parameters of each group were compared and analyzed.Result:Compared with the control group,the left ventricular pre-T1 values and ECV values of DCM group and group LGE(+)and group LGE(-)were increased.And there was no statistically significant difference between the group LGE(+)and group LGE(-).Comparing no signifcant delay enhancement segments between group LGE(+)and LGE(-),the ECV value of no significant delay enhancement segments in group LGE(-)(31.2±2.3)%was higher than group LGE(+)(29.8±2.2)%,with statistical difference(P<0.01).The ECV value of the DCM group was negatively correlated with the left cardiac ejection fraction,r=-0.47,P<0.01.Conclusion:Magnetic resonance T1 mapping is a good predictor of diffuse myocardial fibrosis in patients with dilated cardiomyopathy,especially in patients who have not found significant delayed enhancement.