单倍剂量钆布醇与双倍剂量钆喷酸葡胺在心力衰竭患者心脏MR增强评估心肌纤维化与心肌梗死中的对比研究

Comparison between single-dose Gadobutrol and double-dose Gadopentetate dimeglumine for cardiac late gadolinium enhancement MR imaging of myocardial fibrosis and infarction in heart failure patients

目的:采用MR延迟增强、T_(1)-mapping技术探讨单倍剂量钆布醇和双倍剂量钆喷酸葡胺在心力衰竭患者心肌纤维化与心肌梗死评估中的价值。方法:54例使用钆喷酸葡胺和44例使用钆布醇增强的心力衰竭患者的心脏MR图像用于数据分析。在MR延迟增强、增强后T_(1)-mapping图像上测量左心室血池、正常心肌、延迟强化心肌的信号强度及T_(1)值,计算左心室血池的信噪比(SNR_(LV))、延迟强化心肌的信噪比(SNR_(hyper))、延迟强化心肌和正常心肌之间的对比噪声比(CNR_(hyper-remote))及T_(1)差值(△T1_(hyper-remote))、延迟强化心肌和左心室血池之间的对比噪声比(CNR_(hyper-LV))及T_(1)差值(△T1_(hyper-LV))。结果:钆布醇SNR_(LV)低于钆喷酸葡胺(P<0.001),钆布醇CNR_(hyper-LV)、T1_(LV)和△T1_(hyper-LV)均高于钆喷酸葡胺(P<0.001),且差异均有统计学意义;但两种对比剂的SNR_(hyper)、CNR_(hyper-remote)、T1_(hyper)和△T1_(hyper-remote)之间差异无统计学意义。结论:心力衰竭患者行心脏MR延迟增强检查时,使用单倍剂量钆布醇可比双倍剂量钆喷酸葡胺更好地评估心肌纤维化与心肌梗死情况。

Objective:To investigate the value of single-dose Gadobutrol and double-dose Gadopentetate dimeglumine for the evaluation of fibrotic and infarcted myocardium in heart failure patients using MR late gadolinium enhancement and T_(1)-mapping techniques.Methods:A comparative analysis was conducted on heart failure patients who underwent cardiac MR imaging:54 cases receiving Gadopentetate dimeglumine and 44 cases receiving Gadobutrol.The signal intensity(SI)and T_(1)values of hyper-enhanced myocardium,remote myocardium,and the left ventricular blood pool were measured on MR late gadolinium enhancement and T_(1)-mapping images,respectively.The signal-to-noise ratio(SNR)of hyper-enhanced myocardium(SNR_(hyper))and left ventricular blood pool(SNR_(LV)),the contrast-of-noise ratio(CNR),and the difference of T_(1)values between hyper-enhanced myocardium and remote myocardium(CNR_(hyper-remote)and△T1_(hyper-remote))and between hyper-enhanced myocardium and left ventricular blood pool(CNR_(hyper-LV)and△T1_(hyper-LV))were calculated.Results:SNR LV was significantly lower in Gadobutrol than in Gadopentetate dimeglumine(P<0.001),and CNR_(hyper-LV),T1_(LV)and△T1_(hyper-LV)were significantly higher in Gadobutrol than in Gadopentetate dimeglumine(P<0.001).However,no significant difference was found between the two contrast agents in SNR hyper,CNR_(hyper-remote),T1 hyper,and△T1_(hyper-remote).Conclusion:Single-dose Gadobutrol may provide a more accurate assessment evaluation of fibrotic and infarcted myocardium in heart failure patients who are recommended to undergo cardiac late gadolinium enhancement MR imaging,compared to double-dose Gadopentetate dimeglumine.