MRI-T2*评价β-地中海贫血患者心肌铁沉积及其与左心室功能、心外膜脂肪的相关性

Significance of MRI-T2* in the evaluation of cardiac iron deposition in patients with β-thalassemia major and its relevance to left ventricular function and epicardial adipose

目的 探究心脏磁共振成像T2*技术在评价β-地中海贫血(β-TM)患者心肌铁沉积程度及其与左心室容积参数、心外膜脂肪组织(EAT)关系的意义。方法 采用心脏磁共振电影序列、T2*序列技术测量115例β-TM患者的心肌T2*值、左心室功能参数、EAT,根据心肌铁沉积情况将其分为正常组、轻度组、中度组和重度组。比较4组患者左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、每搏输出量(SV)、心输出量(CO)及心外膜脂肪组织(EAT)体积的差异,并分析其相关性。结果 正常组、轻度组、中度组、重度组的LVEF依次降低(P<0.01),LVEDV、LVESV、EAT体积均依次升高(P<0.01);β-TM患者心肌T2*值与LVEDV、LVESV及EAT体积均呈负相关(P<0.001)。结论 心脏MRI-T2*可定量评估β-TM患者心肌铁沉积程度,且心肌T2*值与患者的左心室功能形态参数呈负相关。

Objective To explore the significance of MRI-T2* in the evaluation of cardiac iron deposition in patients with β-thalassemia major(β-TM) and its correlation with left ventricular function and epicardial adipose tissues(EAT).Methods Cardiac magnetic resonance imaging sequences and T2* sequence technology were used to measure the myocardial T2* value,left ventricular function parameters and EAT of 115 β-TM patients.The patients were divided into the Normal,Mild,Moderate,and Severe Group according to the cardiac iron deposition.The left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),stroke volume(SV),cardiac output(CO),and epicardial adipose tissue(EAT) volume were compared among the 4 groups.The correlation between them was analyzed.Results The LVEFs of the Normal,Mild Group,Moderate and Severe Group decreased successively(P<0.01),while the LVEDVs,LVESVs,and EAT volumes of the four groups all increased successively(P<0.01);the myocardial T2* values of β-TM patients were negatively correlated with LVEDV,LVESV,and EAT volume(P<0.001).Conclusion Cardiac MRI-T2*can quantitatively evaluate the cardiac iron deposition of β-TM patients.The cardiac T2* value of β-TM patients is negatively correlated with their left ventricular function parameters.