Division of Cardiothoracic Imaging, Department of Medical Imaging, University Health Network and Mount Sinai Hospital, Toronto, Canada.
J Magn Reson Imaging. 2009 Nov;30(5):942-6. doi: 10.1002/jmri.21918.
To evaluate cardiac MRI (CMR) in the diagnosis of cardiac amyloidosis by comparing the T2 relaxation times of left ventricular myocardium in a pilot patient group to a normal range established in healthy controls.
Forty-nine patients with suspected amyloidosis-related cardiomyopathy underwent comprehensive CMR examination, which included assessment of myocardial T2 relaxation times, ventricular function, resting myocardial perfusion, and late gadolinium enhancement (LGE) imaging. T2-weighted basal, mid, and apical left ventricular slices were acquired in each patient using a multislice T2 magnetization preparation spiral sequence. Slice averaged T2 relaxation times were subsequently calculated offline and compared to the previously established normal range.
Twelve of the 49 patients were confirmed to have cardiac amyloidosis by biopsy. There was no difference in mean T2 relaxation times between the amyloid cases and normal controls (51.3 +/- 8.1 vs. 52.1 +/- 3.1 msec, P = 0.63). Eleven of the 12 amyloid patients had abnormal findings by CMR, eight having LGE involving either ventricles or atria and four demonstrating resting subendocardial perfusion defects.
CMR is a potentially valuable tool in the diagnosis of cardiac amyloidosis. However, calculation of myocardial T2 relaxation times does not appear useful in distinguishing areas of amyloid deposition from normal myocardium.
通过将疑似心脏淀粉样变性相关心肌病患者的左心室心肌 T2 弛豫时间与健康对照组的正常范围进行比较，评估心脏 MRI（CMR）在心脏淀粉样变性诊断中的作用。
49 例疑似淀粉样变性相关性心肌病患者接受了全面的 CMR 检查，包括心肌 T2 弛豫时间、心室功能、静息心肌灌注和晚期钆增强（LGE）成像评估。采用多层面 T2 磁化准备螺旋序列在每位患者的左心室基底、中部和心尖层面采集 T2 加权基础、中部和心尖层面。随后离线计算层平均 T2 弛豫时间，并与先前建立的正常范围进行比较。
49 例患者中，12 例经活检证实为心脏淀粉样变性。淀粉样病例与正常对照组的平均 T2 弛豫时间无差异（51.3 +/- 8.1 与 52.1 +/- 3.1 msec，P = 0.63）。12 例淀粉样病例中有 11 例 CMR 检查结果异常，8 例存在心室或心房 LGE，4 例存在静息心内膜下灌注缺损。
CMR 是诊断心脏淀粉样变性的一种很有价值的工具。然而，计算心肌 T2 弛豫时间似乎无法用于区分淀粉样沉积区与正常心肌。
