2 型糖尿病患者的收缩性心肌功能障碍：电影位移编码的刺激回波磁共振成像的识别。
Systolic myocardial dysfunction in patients with type 2 diabetes mellitus: identification at MR imaging with cine displacement encoding with stimulated echoes.
机构信息
Service des Explorations Fonctionnelles Cardiovasculaires, Department of Endocrinology, Louis Pradel Hospital, CarMeN INSERM Unit 1060, Université de Lyon, Lyon, France.
出版信息
Radiology. 2012 Nov;265(2):402-9. doi: 10.1148/radiol.12112571. Epub 2012 Aug 28.
PURPOSE
To determine if cine displacement encoding with stimulated echoes (DENSE) can help to identify and determine the patterns of subclinical myocardial systolic dysfunction in patients with type 2 diabetes mellitus (DM) when compared with cine DENSE in control patients.
MATERIALS AND METHODS
After obtaining approval from the institutional ethics committee and written informed consent from the patients, 37 patients with type 2 DM without overt heart disease and 23 age-matched control patients were prospectively included in the study. The patients underwent standard cine magnetic resonance (MR) imaging with two-dimensional cine DENSE acquisitions. Circumferential (Ecc) and radial (Err) systolic strains were measured on short-axis views at basal, mid, and apical left ventricular levels. Longitudinal strain (Ell) was measured on four- and two-chamber views. Statistical testing included the intraclass correlation coefficient and multiple linear regression analysis.
RESULTS
The intraobserver intraclass correlation coefficient values were 0.85, 0.95, and 0.90, and the interobserver intraclass correlation coefficient values were 0.79, 0.91 and 0.80 for Ecc, Err, and Ell, respectively. The left ventricular ejection fraction was in the reference range and similar between the groups, and the patients with DM showed a decrease in Ecc (-14.4%±1.6 vs -17.0%±1.6, P<.001), Err (36.2%±10.9 vs 44.4%±9.9, P=.006) and Ell (-12.9%±2.1 vs -15.5%±1.6, P<.001) compared with the control patients. Finally, DM was independently associated with Ecc (P<.001), Err (P=.05) and Ell (P=.01) after adjustment for age, sex, hypertension, body mass index, and left ventricular mass.
CONCLUSION
Cine DENSE, a motion-encoding MR imaging technique for myocardial strain assessment with high spatial resolution, appears to be useful in the identification of subclinical myocardial dysfunction in patients with DM.
目的
通过与对照患者的电影型 DENSE（电影位移编码用激发回波）相比，确定电影型 DENSE 是否有助于识别和确定 2 型糖尿病（DM）患者亚临床心肌收缩功能障碍的模式。
材料与方法
在获得机构伦理委员会的批准并获得患者书面知情同意后，前瞻性纳入 37 名无明显心脏疾病的 2 型 DM 患者和 23 名年龄匹配的对照患者。患者接受二维电影型 DENSE 采集的标准电影型磁共振（MR）成像。在基底、中部和心尖左心室水平的短轴视图上测量圆周（Ecc）和径向（Err）收缩应变。在四腔和两腔视图上测量纵向应变（Ell）。统计检验包括组内相关系数和多元线性回归分析。
结果
观察者内的组内相关系数值分别为 0.85、0.95 和 0.90，观察者间的组内相关系数值分别为 0.79、0.91 和 0.80，用于 Ecc、Err 和 Ell。左心室射血分数在参考范围内，两组之间相似，DM 患者的 Ecc（-14.4%±1.6 比-17.0%±1.6，P<.001）、Err（36.2%±10.9 比 44.4%±9.9，P=.006）和 Ell（-12.9%±2.1 比-15.5%±1.6，P<.001）较对照组患者降低。最后，在调整年龄、性别、高血压、体重指数和左心室质量后，DM 与 Ecc（P<.001）、Err（P=.05）和 Ell（P=.01）独立相关。
结论
电影型 DENSE 是一种具有高空间分辨率的心肌应变评估运动编码磁共振成像技术，似乎可用于识别 DM 患者的亚临床心肌功能障碍。
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