Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Am J Cardiol. 2010 Aug 15;106(4):483-91. doi: 10.1016/j.amjcard.2010.03.063.
We introduce and evaluate strain mapping by multidetector computer tomography as a new noninvasive method for assessment of myocardial function. In patients (n = 16) with healed myocardial infarction, peak systolic radial strain was measured by automated pixel pattern matching analysis of multiple left ventricular 64-slice multidetector computer tomographic short-axis recordings. For comparison, radial strain and myocardial infarct extent were measured by tagged magnetic resonance imaging (MRI) and late enhancement MRI, respectively. In a linear mixed model analysis, myocardial infarct extent was a strong predictor of segmental strain by multidetector computer tomography (beta = -0.44, p <0.0001). Strain was significantly different among noninfarcted (0%), nontransmurally infarcted (0% to 50%), and transmurally infarcted (>50%) segments (p <0.001) and between infarcted and noninfarcted border zone segments (p <0.001). There was a close relation between strain by multidetector computer tomography and by tagged MRI (mean difference -7.4 +/- 11.7%, r = 0.68, p <0.0001). Mean time-to-peak systolic strain was 324 +/- 42 ms by multidetector computer tomography and 335 +/- 56 ms by tagged MRI (mean difference 11 +/- 40 ms). In conclusion, to our knowledge this is the first study to demonstrate that regional myocardial function can be quantified by multidetector computer tomographic imaging, indicating that assessment of radial strain by multidetector computer tomography might be a useful tool in the evaluation of patients with cardiovascular diseases.
我们介绍并评估了通过多排螺旋 CT 进行应变绘图的方法，该方法是一种评估心肌功能的新的无创方法。在 16 例愈合性心肌梗死患者中，通过对 64 层多排螺旋 CT 短轴图像的多个左心室进行自动像素匹配分析，测量收缩期峰值径向应变。为了进行比较，还通过 MRI 进行了心肌应变和心肌梗死范围的测量。在线性混合模型分析中，心肌梗死范围是多排螺旋 CT 节段应变的一个强有力的预测因素（β = -0.44，p <0.0001）。应变在非梗死区（0%）、非透壁梗死区（0%~50%）和透壁梗死区（>50%）之间存在显著差异（p <0.001），并且在梗死区和非梗死区交界区之间也存在显著差异（p <0.001）。多排螺旋 CT 应变与 MRI 标记之间存在密切关系（平均差异 -7.4 +/- 11.7%，r = 0.68，p <0.0001）。多排螺旋 CT 达收缩峰值的平均时间为 324 +/- 42 ms，而 MRI 标记的时间为 335 +/- 56 ms（平均差异 11 +/- 40 ms）。总之，据我们所知，这是第一项表明可以通过多排螺旋 CT 成像定量评估局部心肌功能的研究，表明多排螺旋 CT 评估径向应变可能是评估心血管疾病患者的有用工具。
