TI-scout图像评估轻链型心肌淀粉样变延迟强化的价值

Usefulness of TI-scout images in the assessment of late gadolinium enhancement in light chain cardiac amyloidosis

目的:探索TI-scout图像定性评估轻链型心肌淀粉样变患者病变心肌延迟强化(LGE)价值。方法:回顾性分析2016年7月至2022年7月就诊于广东省人民医院的129例轻链型心肌淀粉样变患者临床及心脏磁共振影像(CMR)资料。基于TI-scout图像和相位敏感反转恢复(PSIR)图像评估LGE,两者诊断性能分为以下4种情况,TI-scout图像诊断性能与PSIR图像比较:①优于;②互补;③相等;④差于。将①和②定义为TI-scout图像有助于诊断LGE。结果:129例患者中27例为LGE阴性、102例LGE阳性。在LGE阴性患者中,74%患者TI-scout图像有助于LGE阴性的诊断。在LGE阳性患者中,65%病例TI scout图像有助于病变心肌LGE诊断,其中33%心内膜下LGE、28%透壁型LGE、29%局灶斑片型LGE,基于TI-scout图像诊断性能优于短轴PSIR图像。在20%心内膜下LGE、38%透壁型LGE、42%局灶斑片型LGE患者中两种图像诊断性能为互补。结论:TI scout图像有助于识别轻链型心肌淀粉样变患者病变心肌LGE。

Objective:To investigate diagnostic value of the TI-scout images in the identification of late-gadolinium enhancement(LGE)of abnormal myocardium in patient with light chain cardiac amyloidosis(AL-CA).Methods:Cardiac magnetic resonance(CMR)data of 129 patients with AL-CA admitted to Guangdong Provincial People's Hospital from July 2016 to July 2022 were reviewed.LGE was evaluated based on TI-scout images and phase-sensitive inversion recovery(PSIR)images.The diagnostic performance was classified into four categories:TI-scout images compared with PSIR images:①superior;②complementary;③equally diagnostic;④inferior.Defining①and②as TI-scout images helps to diagnose the LGE.Results:Of the 129 patients,27 were LGE negative and 102 were LGE positive.In the LGE-negative patients,TI-scout images contributed to the diagnosis of LGE-negative in 74%of cases.In LGE-positive patients,TI-scout images contributed to the diagnosis of LGE in 65%of cases.Among them,33%of the subendocardial LGE,28%of the transmural LGE,and 29%of the focal patchy LGE had better diagnostic performance based on TI-scout images than PSIR images.The diagnostic performance of the two images was complementary in 20%of patients with subendocardial LGE,38%with transmural LGE,and 42%with focal patchy LGE.Conclusion:TI-scout images enhance the diagnostic performance of LGE imaging in patient with light chain cardiac amyloidosis.