Yang Yuesong, Safka Katherine, Graham John J, Roifman Idan, Zia Mohammad I, Wright Graham A, Balter Meyer, Dick Alexander J, Connelly Kim A
Imaging Research and Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
J Magn Reson Imaging. 2014 Mar;39(3):609-16. doi: 10.1002/jmri.24196. Epub 2013 May 29.
To investigate the potentially improved detection and quantification of cardiac involvement using novel late-gadolinium-enhancement (LGE) cardiac magnetic resonance imaging (MRI) and quantitative T2 measurement to achieve better myocardial tissue characterization in systemic sarcoidosis.
Twenty-eight patients with systemic sarcoidosis underwent a cardiac magnetic resonance imaging (CMR) study on a 1.5T system. Precontrast CMR included left ventricular (LV) and right ventricular (RV) function and quantitative T2 measurement. Postcontrast LGE-MRI included inversion-recovery fast-gradient-echo (IR-FGRE) and multicontrast late-enhancement imaging (MCLE).
LV functional parameters were normal in all patients (LVEF=61.2±8.5%) including with cardiac involvement (LVEF=59.4±12.1%) and without (LVEF=61.7±7.5%) while the average RV function was comparatively decreased (RVEF=48.0±6.6%, P<0.0001). 21.4% of patients had cardiac involvement showing patchy or multiple focal hyperenhancement patterns in LV free wall, papillary muscles (PM), or interventricular septum. In two cases with PM involvement, the PM abnormal LGE foci were only observed on MCLE. For precontrast T2 measurements, a significantly decreased T2 measurement was observed in regions demonstrating LGE, compared to the LGE-negative group (focal LGE-positive regions vs. negative: 40.0±2.4 msec vs. 53.0±2.6 msec, P<0.0001).
LGE-MRI can identify cardiac involvement in systemic sarcoidosis. MCLE might be more sensitive at detecting subtle myocardial lesion. The decreased T2 observed in cardiac sarcoid may reflect its inactive phase, thus might provide a noninvasive method for monitoring disease activity or therapy.
利用新型延迟钆增强（LGE）心脏磁共振成像（MRI）和定量T2测量，研究在系统性结节病中对心脏受累情况进行潜在改进的检测和定量分析，以实现更好的心肌组织特征描述。
28例系统性结节病患者在1.5T系统上接受了心脏磁共振成像（CMR）检查。对比剂注射前的CMR包括左心室（LV）和右心室（RV）功能以及定量T2测量。对比剂注射后的LGE-MRI包括反转恢复快速梯度回波（IR-FGRE）和多对比延迟增强成像（MCLE）。
所有患者的LV功能参数均正常（左心室射血分数[LVEF]=61.2±8.5%），包括有心脏受累者（LVEF=59.4±12.1%）和无心脏受累者（LVEF=61.7±7.5%），而平均RV功能相对降低（右心室射血分数[RVEF]=48.0±6.6%，P<0.0001）。21.4%的患者有心脏受累，表现为LV游离壁、乳头肌（PM）或室间隔出现斑片状或多发局灶性强化模式。在2例有PM受累的病例中，仅在MCLE上观察到PM异常LGE病灶。对于对比剂注射前的T2测量，与LGE阴性组相比，在显示LGE的区域观察到T2测量值显著降低（局灶性LGE阳性区域与阴性区域：40.0±2.4毫秒对53.0±2.6毫秒，P<0.0001）。
LGE-MRI可识别系统性结节病中的心脏受累情况。MCLE在检测细微心肌病变方面可能更敏感。在心脏结节病中观察到的T2降低可能反映其静止期，因此可能为监测疾病活动或治疗提供一种非侵入性方法。
