心脏MR T1mapping技术在2型糖尿病早期心肌损伤中的应用

目的探讨MR T1 mapping技术在2型糖尿病(T2DM)早期心肌损伤的应用价值。方法对30例T2DM病程早期及30例健康志愿者采用心脏MR T1mapping技术行心脏MR检查。测量并比较两组间左心室相关参数、各节段心肌及各冠状动脉供血区心肌Native T1值、增强后T1值、ECV值,并绘制ROC曲线进一步评估各参数值的诊断价值。结果T2DM组平均EF值低于健康对照组,T2DM组的ECV值高于健康对照组,且差异有统计学意义(P<0.05)。RCA供血区和LCX供血区T2DM患者的增强后T1值、ECV值均高于健康对照组,且差异有统计学意义(P<0.05)。ROC曲线结果显示ECV值对于T2DM早期心肌损伤具有较高的诊断价值(AUC>0.9)。结论心脏MR T1 mapping技术可用于定量评价糖尿病心肌损伤,其中ECV值对2型糖尿病早期心肌损伤具有较高的预测价值,可用于2型糖尿病患者早期心肌损伤的评估。

Objective To investigate the application value of magnetic resonance(MR)T1 mapping technique in early myocardial injury of type 2 diabetes mellitus(T2DM).Methods Thirty patients with T2DM in the early stage and thirty healthy volunteers were examined by cardiac MR T1 mapping.The left ventricular parameters,native T1,enhanced T1 and ECV were measured and compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to further evaluate the diagnostic value of each parameter value.Results The average ejection fraction(EF)value of T2DM group was lower than that of healthy control group,and the extracellular volume(ECV)value of T2DM group was higher than that of healthy control group,and the difference was statistically significant(P<0.05).The enhanced T1 and ECV values of T2DM patients in right coronary artery(RCA)and left Circumflex Artery(LCX)blood supply areas were higher than those in healthy control group,and the difference was statistically significant(P<0.05).ROC curve showed that ECV value had a high diagnostic value for early myocardial injury in T2DM(area under curve(AUC)>0.9).Conclusion Cardiac MR T1 mapping technique can be used to quantitatively evaluate diabetic myocardial injury.ECV value has a high predictive value for early myocardial injury in type 2 diabetes mellitus patients,and can be used for early myocardial injury assessment in patients with type 2 diabetes mellitus.