心脏MRI mapping技术在飞行员心肌组织评估中的初步探索

Preliminary study on assessment of myocardium in pilots by cardiac MRI mapping

目的通过无创、无辐射的心脏MRI mapping技术初步评估飞行员心肌组织状况, 探讨该技术在飞行员心肌组织评估中的应用价值。方法采用病例对照研究方法。研究对象为2020年10月至2022年7月于空军特色医学中心行心脏MRI检查的飞行员和普通人员。按照年龄分为20~40岁组及>40岁组, 分析比较同年龄段飞行员和普通人员心肌纵向弛豫时间(T1值)、横向弛豫时间(T2、T2*值)的差异。将飞行员分别按飞行时间和飞行机种进行分组, 分析比较不同飞行时间及飞行机种飞行员心肌T1、T2及T2*值的差异。结果飞行员总体心肌平均T1值[(1 011.18±24.70)ms]低于普通人员[(1 025.07±25.74)ms], 差异有统计学意义(t=2.10, P=0.040)。>40岁组飞行员心肌T1值[(1 006.04±29.15)ms]低于普通人员[(1 029.68±20.24)ms], 差异有统计学意义(t=2.30, P=0.032)。歼击机飞行员心肌T1值[(999.04±17.39)ms]低于轰、运、直机飞行员[(1 023.33±25.53)ms], 差异有统计学意义(t=2.73, P=0.012)。20~40岁飞行员和普通人员心肌T1、T2、T2*值及>40岁飞行员和普通人员T2、T2*值比较, 差异均无统计学意义(P均>0.05);不同飞行时间飞行员心肌T1、T2、T2*值差异无统计学意义(P均>0.05)。结论歼击机飞行员心肌细胞肥大或心肌纤维化水平可能低于其他机种飞行员。心脏MRI mapping技术在飞行员心肌组织评估中有潜在的应用价值。

Objective To preliminarily evaluate the myocardium of pilots by noninvasive and radiation free cardiac MRI mapping technology,and to explore its application value in evaluating the myocardium of pilots.Methods Case-control study was adopted in this study.Pilots and normal personnel who had cardiac MRI in Air Force Medical Center from October of 2020 to July of 2022 were selected,and they were divided into 20-40 years group and>40 years group.The differences of myocardial longitudinal relaxation time T1,transverse relaxation time T2 and T2*values between pilots and normal personnel at different ages were analyzed and compared.Pilots were divided into groups according to flying hours and aircraft types,and the differences of myocardial T1,T2 and T2*values among pilots in different flying hours and aircraft types were analyzed and compared.Results The average myocardial T1 value of pilots[(1011.18±24.70)ms]was lower than that of normal personnel[(1025.07±25.74)ms],and the difference was significant(t=2.10,P=0.040).The myocardial T1 value of pilots>40 years old[(1006.04±29.15)ms]was lower than that of normal personnel[(1029.68±20.24)ms],and the difference was significant(t=2.30,P=0.032).The myocardial T1 value of fighter pilots[(999.04±17.39)ms]was lower than that of the bomber,transporter,helicopter pilots[(1023.33±25.53)ms],and the difference was significant(t=2.73,P=0.012).There was no significant difference in myocardial T1,T2 and T2*values between pilots and nornal personnel aged 20-40 years old;there was no significant difference in T2 and T2*values between pilots and normal personnel in the age group of>40 years old(all P>0.05).There was also no significant difference in myocardial T1,T2 and T2*values among the pilots in different flying hours(all P>0.05).Conclusions The level of cardiomyocyte hypertrophy or myocardial fibrosis in fighter pilots might be lower than that in other aircraft types pilots.Cardiac MRI mapping has potential value in evaluating the myocardium of pilots.