磁共振特征追踪技术对维持性血液透析患者心肌形变的评估

MR Feature Tracking in Assessment on Myocardial Deformation in Patients on Maintenance Hemodialysis

目的 探究心脏磁共振特征追踪技术(FT-CMR)对维持性血液透析(MHD)患者心肌形变的诊断价值。方法 前瞻性搜集45例MHD患者,另招募45名健康志愿者作为对照组,两组均行心脏磁共振(CMR)检查,利用FT-CMR,获得左心室心肌应变值,探讨两组人群心肌形变差异。结果 MHD患者左心室心肌整体周向应变(GCS)、径向应力(GRS)和纵向应变(GLS)均低于对照组[(-17.74±7.81)%vs.(-24.53±5.65)%,(36.21±21.41)%vs.(50.33±20.69)%,(-15.99±6.37)%vs.(-24.36±3.36)%,P均<0.05)]。ROC曲线分析结果显示GLS对MHD患者和对照组鉴别诊断的AUC最大(0.884),GLS值>-22.03时,敏感度为0.80,特异度为0.889。结论 FT-CMR评估MHD患者心肌纤维化形变是可行的,有一定的临床应用价值。

Objective To explore the application value of cardiac magnetic resonance(CMR) feature tracking technique in patients on maintenance hemodialysis(MHD).Methods 45 patients with MHD were prospectively collected,and45 normal volunteers were recruited as the control group.CMR examination was performed in both groups,and the left ventricular myocardial strain values were obtained by FT-CMR to explore the differences in myocardial deformation between the two groups.Results The Global circumferential strain(GCS),Global radial strain(GRS) and Global longitudinal strain(GLS) were lower than that of the control group[(-17.74±7.81) % vs.(-24.53±5.65) %,(36.21±21.41) % vs.(50.33±20.69) %,(-15.99±6.37) % vs.(-24.36±3.36) %,all P <0.05)].ROC curve analysis results showed that GLS had the maximum AUC(0.884) in the differential diagnosis of MHD patients and control group.When GLS value was>-22.03,the sensitivity was 80.00% and the specificity was 88.89%.Conclusion It is feasible to evaluate myocardial deformation in patients with MHD by FT-CMR,and it has certain clinical application value.