心脏磁共振DWI序列对肥厚型心肌病心肌纤维化诊断价值及与NT-ProBNP相关性分析

The Diagnosis Value of Diffusion-Weighted Imaging in Hypertrophic Cardiomyopathy and Its Correlation with The NT-ProBNP

目的 通过研究心脏磁共振DWI序列对肥厚型心肌病心肌纤维化ADC值的变化,探讨该序列对肥厚型心肌病心肌纤维化的诊断价值。方法 选取66例临床诊断为HCM的患者及21例正常志愿者行心脏磁共振成像(CMR)检查[包括心脏电影、DWI、延迟钆对比剂增强(LGE)]。分别记录HCM患者与正常志愿者相同心肌节段ADC值的变化,并观察相同节段心肌LGE有无强化;HCM组与正常组相同心肌节段ADC值采用独立样本t检验,P<0.05有统计学意义;并记录患者首次抽血检查血浆中氨基未端B型脑钠肽前体(NT-proBNP),将其与ADC值进行相关性分析。结果 肥厚型心肌病肥厚节段ADC值高于正常组ADC值,差异具有统计学意义;NT-ProBNP升高组ADC值高于NT-ProBNP正常组,差异有统计学意义;LGE阳性较LGE阴性组ADC值升高,但差异无统计学意义。结论 磁共振DWI序列ADC值测定对鉴别肥厚型心肌病心肌纤维化具有一定的临床价值。

Objective to explore the value of cardiac magnetic resonance DWI sequence in the diagnosis of myocardial fibrosis in hypertrophic cardiomyopathy by studying the changes of ADC value of myocardial fibrosis in hypertrophic cardiomyopathy. Methods cardiac magnetic resonance imaging((CMR)) was performed in 66 patients with clinically diagnosed HCM and 21 normal volunteers [including cardiac film, DWI, delayed gadolinium contrast enhanced(LGE)]. The changes of ADC values of the same myocardial segments in patients with HCM and normal volunteers were recorded, and the enhancement of LGE in the same segments of myocardium was observed. The ADC values of the same myocardial segments in the HCM group and the normal group were tested by independent sample t-test, P<0.05.The plasma N-terminal B-type natriuretic peptide(NT-pro BNP) was detected for the first time, and the correlation between ADC value and ADC value was analyzed. Results the ADC value of hypertrophic cardiomyopathy was higher than that of normal group, the difference was statistically significant, the ADC value of NT-Pro BNP elevated group was higher than that of NT-Pro BNP normal group, and the ADC value of LGE positive group was higher than that of LGE negative group, but the difference was not statistically significant. Conclusion the determination of ADC value of magnetic resonance DWI sequence has certain clinical value in differential diagnosis of myocardial fibrosis in hypertrophic cardiomyopathy.