心脏磁共振在评估肝豆状核变性心肌受累中的应用

Cardiac Magnetic Resonance in the Evaluation of Myocardial Involvement in Wilson’s Disease

目的探讨心脏磁共振(CMR)在评估肝豆状核变性(WD)心肌受累中的应用价值。资料与方法回顾性收集2022年4—6月于安徽医科大学第一附属医院行CMR检查的12例WD患者作为研究组,同时纳入年龄、性别、体重指数、体表面积与研究组匹配的12例健康志愿者作为对照组。收集受试者的临床基线资料、心电图及CMR结果。CMR定量参数包括左心室射血分数、左心室舒张末期容积指数、左心室每搏输出量指数、左心室T1值、T2值、细胞外容积分数、右心室射血分数、右心室舒张末期容积指数、右心室每搏输出量指数,比较两组CMR定量参数的差异。结果1例WD患者左心室室间隔处可见心肌裂。12例WD患者中,心肌延迟增强阳性2例,均位于室间隔右心室插入部。WD患者初始T1值[(1092.4±50.3)ms]、T2值[(53.8±2.0)ms]与细胞外容积分数[(31.7±3.5)%]较对照组[(1039.8±38.1)ms、(51.0±2.7)ms、(25.8±1.0)%]均显著升高(t=2.893、2.904、5.635,P均<0.05)。研究组与对照组左心室射血分数、左心室舒张末期容积指数、左心室每搏输出量指数、右心室射血分数、右心室舒张末期容积指数、右心室每搏输出量指数比较,差异均无统计学意义(t=0.322、0.520、0.665、0.913、0.731、0.828,P均>0.05)。结论CMR对于早期发现WD心肌受累具有一定的价值,可作为WD患者疑似心脏受累检查的重要方法。

Purpose To evaluate the value of cardiac magnetic resonance(CMR)in myocardial involvement in patients with Wilson’s disease(WD).Materials and Methods A total of 12 patients with WD who underwent CMR in the First Affiliated Hospital of Anhui Medical University from April to June 2022 were retrospectively included.A total of 12 age-,gender-,body mass index-,body surface areamatched healthy volunteers(control group)were included in the same period.The baseline clinical data,electrocardiogram data and CMR images of all WD patients and volunteers were obtained.CMR quantitative parameters included left ventricular ejection fraction,left ventricular enddiastolic volume index,left ventricular stroke volume index,T1 and T2 value of left ventricular,extracellular volume,right ventricular ejection fraction,right ventricular end-diastolic volume index,right ventricular stroke volume index.The differences of these CMR parameters between WD group and control group was compared.Results Myocardial fissure was only observed in the left ventricular septum in 1 case with WD.Of the 12 WD patients,there were 2 WD patients with positive late gadolinium enhancement,which were all located in the right ventricular insertion part of the interventricular septum.The values of native T1[(1092.4±50.3)ms],T2[(53.8±2.0)ms]and extracellular volume[(31.7±3.5)%]in WD group were significantly higher than those in the control group[(1039.8±38.1)ms,(51.0±2.7)ms,(25.8±1.0)%](t=2.893,2.904,5.635,all P<0.05).There were no significant differences in left ventricular ejection fraction,left ventricular end-diastolic volume index,left ventricular stroke volume index,right ventricular ejection fraction,right ventricular end-diastolic volume index and right ventricular stroke volume index between WD group and control group(t=0.322,0.520,0.665,0.913,0.731,0.828,all P>0.05).Conclusion CMR can be valuable for the early detection of myocardial involvement in patients with WD,and can be considered as an important examination method for suspected cardiac involvement in WD patients.