Nassenstein K, Breuckmann F, Huger M, Ladd S C, Schlosser T, Kreuter A, Barkhausen J
Abteilung für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Essen.
Rofo. 2008 Dec;180(12):1054-60. doi: 10.1055/s-2008-1027864. Epub 2008 Nov 13.
Our study aimed to assess the prevalence and pattern of late gadolinium enhancement (LGE) as an in vivo correlate of myocardial fibrosis in cardiac asymptomatic patients with systemic sclerosis (SSc).
Cardiac magnetic resonance imaging was successfully performed in 34 patients (30 female, 4 male, mean age of 54 +/- 14 years) with proven SSc and in controls with matching age, sex and cardiovascular risk factors. All examinations were performed on a 1.5 T MR system (Avanto, Siemens, Germany). 2D inversion recovery spoiled gradient echo images (TR 8.0 msec, TE 4.0 msec, TI 180 - 240 msec, FA 20 degrees, slice thickness 8 mm, in-plane resolution 1.2 x 1.2 mm (2)) were acquired 10 to 15 min after injection of 0.2 mmol Gd-DTPA per kg body weight to detect myocardial LGE.
Poorly defined, patchy as well as well-defined focal areas of LGE were detected predominantly in the mid-myocardial layer of the basal left ventricular segments in 5 of 34 (15 %) SSc patients. A focal area of LGE was observed within the apical septum in one control (3 %, p > 0.05). LGE was observed in a total of 15 segments of the SSc patients and in 1 segment of the controls (p < 0.005).
Our results revealed a significantly higher number of LGE positive segments in patients with SSc compared to matched controls, and demonstrate the ability of contrast-enhanced MRI to detect myocardial fibrosis, the hallmark of scleroderma heart disease, in-vivo.
我们的研究旨在评估延迟钆增强（LGE）的发生率和模式，将其作为系统性硬化症（SSc）无症状心脏患者心肌纤维化的一种体内相关性指标。
对34例经证实患有SSc的患者（30例女性，4例男性，平均年龄54±14岁）以及年龄、性别和心血管危险因素相匹配的对照组进行了心脏磁共振成像检查。所有检查均在1.5T磁共振系统（德国西门子Avanto）上进行。在每千克体重注射0.2mmol钆喷酸葡胺后10至15分钟采集二维反转恢复扰相梯度回波图像（TR 8.0毫秒，TE 4.0毫秒，TI 180 - 240毫秒，翻转角20°，层厚8mm，平面分辨率1.2×1.2mm²）以检测心肌LGE。
在34例SSc患者中的5例（15%）中，主要在左心室基底节段的心肌中层检测到边界不清、斑片状以及边界清晰的局灶性LGE区域。在1例对照组患者的心尖间隔内观察到一个局灶性LGE区域（3%，p>0.05）。SSc患者共15个节段出现LGE，对照组为1个节段（p<0.005）。
我们的结果显示，与匹配的对照组相比，SSc患者中LGE阳性节段的数量显著更多，并证明了对比增强磁共振成像在体内检测心肌纤维化（硬皮病性心脏病的标志）的能力。
