Department of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
JACC Cardiovasc Imaging. 2010 Feb;3(2):144-51. doi: 10.1016/j.jcmg.2009.11.006.
To compare a steady-state free precession cine sequence-based technique (feature tracking [FT]) to tagged harmonic phase (HARP) analysis for peak average circumferential myocardial strain (epsilon(cc)) analysis in a large and heterogeneous population of boys with Duchenne muscular dystrophy (DMD).
Current epsilon(cc) assessment techniques require cardiac magnetic resonance-tagged imaging sequences, and their analysis is complex. The FT method can readily be performed on standard cine (steady-state free precession) sequences.
We compared mid-left ventricular whole-slice epsilon(cc) by the 2 techniques in 191 DMD patients grouped according to age and severity of cardiac dysfunction: group B: DMD patients 10 years and younger with normal ejection fraction (EF); group C: DMD patients older than 10 years with normal EF; group D: DMD patients older than 10 years with reduced EF but negative myocardial delayed enhancement (MDE); group E: DMD patients older than 10 years with reduced EF and positive MDE; and group A: 42 control subjects. Retrospective, offline analysis was performed on matched tagged and steady-state free precession slices.
For the entire study population (N = 233), mean FT epsilon(cc) values (-13.3 +/- 3.8%) were highly correlated with HARP epsilon(cc) values (-13.6 +/- 3.4%), with a Pearson correlation coefficient of 0.899. The mean epsilon(cc) of DMD patients determined by HARP (-12.52 +/- 2.69%) and FT (-12.16 +/- 3.12%) was not significantly different (p = NS). Similarly, the mean epsilon(cc) of the control subjects by determined HARP (-18.85 +/- 1.86) and FT (-18.81 +/- 1.83) was not significantly different (p = NS). Excellent correlation between the 2 methods was found among subgroups A through E, except there was no significant difference in strain between groups B and C with FT analysis.
FT-based assessment of epsilon(cc) correlates highly with epsilon(cc) derived from tagged images in a large DMD patient population with a wide range of cardiac dysfunction and can be performed without additional imaging.
比较基于稳态自由进动电影序列的技术(特征跟踪[FT])与标记谐波相位(HARP)分析,以评估患有杜氏肌营养不良症(DMD)的男孩中大量异质人群的峰值平均圆周心肌应变(epsilon(cc))。
目前的 epsilon(cc)评估技术需要心脏磁共振标记成像序列,并且其分析较为复杂。FT 方法可以在标准电影(稳态自由进动)序列上轻松进行。
我们根据年龄和心功能障碍严重程度将 191 名 DMD 患者分为 5 组:B 组:10 岁及以下、射血分数正常的 DMD 患者;C 组:年龄大于 10 岁、射血分数正常的 DMD 患者;D 组:年龄大于 10 岁、射血分数降低但心肌延迟强化(MDE)阴性的 DMD 患者;E 组:年龄大于 10 岁、射血分数降低且 MDE 阳性的 DMD 患者;A 组:42 名对照受试者。对匹配的标记和稳态自由进动切片进行回顾性离线分析。
对于整个研究人群(N=233),FT epsilon(cc)值(-13.3±3.8%)与 HARP epsilon(cc)值(-13.6±3.4%)高度相关,Pearson 相关系数为 0.899。通过 HARP 确定的 DMD 患者的平均 epsilon(cc)(-12.52±2.69%)和 FT(-12.16±3.12%)没有显著差异(p=NS)。同样,通过 HARP 确定的对照组的平均 epsilon(cc)(-18.85±1.86)和 FT(-18.81±1.83)也没有显著差异(p=NS)。在 A 至 E 组亚组中,两种方法之间均存在良好的相关性,但 FT 分析显示 B 组和 C 组之间的应变无显著差异。
在具有广泛心功能障碍的大型 DMD 患者群体中,FT 评估 epsilon(cc)与标记图像衍生的 epsilon(cc)高度相关,并且无需额外成像即可进行。