四腔心电影 MR 成像中纵向应变分析评估心脏不同步。
Evaluation of cardiac dyssynchrony with longitudinal strain analysis in 4-chamber cine MR imaging.
机构信息
Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582, Japan; Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582, Japan.
出版信息
Eur J Radiol. 2013 Dec;82(12):2212-6. doi: 10.1016/j.ejrad.2013.06.014. Epub 2013 Aug 1.
PURPOSE
We investigated the clinical performance of evaluation of cardiac mechanical dyssynchrony with longitudinal strain analysis using four-chamber (4CH) cine magnetic resonance imaging (MRI).
MATERIALS AND METHODS
We retrospectively enrolled 73 chronic heart failure patients (41 men, 32 women; mean age, 57 years, NYHA 2, 3, and 4) who underwent a cardiac MRI in the present study. The left ventricular dyssynchrony (LVD) and interventricular dyssynchrony (IVD) indices were calculated by longitudinal strain analysis using 4 CH cine MRI. The LVD and IVD indices were compared by the Wilcoxon rank-sum test between the patients with indication for cardiac resynchronization therapy (CRT) (n = 13) and without indication for CRT (n = 60), with LGE (n = 40) and without LGE (n = 27), the CRT responders (n = 8) and non-responders (n = 6), respectively.
RESULTS
LVD in the patients with indication for CRT were significantly longer than those without indication for CRT (LVD: 92 ± 65 vs. 28 ± 40 ms, P<.01). LVD and IVD were significantly longer in the patients with LGE than those without LGE (LVD: 54 ± 58 vs. 21 ± 30 ms, P<.01 and IVD: 51 ± 39 vs. 23 ± 34 ms, P<.01). LVD and IVD in the CRT responders were significantly longer than the CRT non-responders (LVD: 126 ± 55 vs. 62 ± 55 ms, P<.01 and IVD: 96 ± 39 vs. 52 ± 40 ms, P<.05).
CONCLUSION
Longitudinal strain analysis with 4CH cine MRI could be useful for clinical examination in the evaluation of cardiac mechanical dyssynchrony.
目的
我们研究了使用四腔（4CH）电影磁共振成像（MRI）评估心肌机械不同步的临床性能。
材料和方法
本研究回顾性纳入了 73 例慢性心力衰竭患者（41 名男性，32 名女性；平均年龄 57 岁，NYHA 2、3 和 4），这些患者均在本研究中接受了心脏 MRI 检查。使用 4CH 电影 MRI 进行纵向应变分析来计算左心室不同步（LVD）和室间不同步（IVD）指数。通过 Wilcoxon 秩和检验比较了有心脏再同步治疗（CRT）适应证（n = 13）和无 CRT 适应证（n = 60）、有和无晚期钆增强（LGE）（n = 40 和 n = 27）、CRT 应答者（n = 8）和非应答者（n = 6）的 LVD 和 IVD 指数。
结果
有 CRT 适应证的患者的 LVD 明显长于无 CRT 适应证的患者（LVD：92 ± 65 比 28 ± 40 ms，P<.01）。有 LGE 的患者的 LVD 和 IVD 明显长于无 LGE 的患者（LVD：54 ± 58 比 21 ± 30 ms，P<.01 和 IVD：51 ± 39 比 23 ± 34 ms，P<.01）。CRT 应答者的 LVD 和 IVD 明显长于非 CRT 应答者（LVD：126 ± 55 比 62 ± 55 ms，P<.01 和 IVD：96 ± 39 比 52 ± 40 ms，P<.05）。
结论
使用 4CH 电影 MRI 进行纵向应变分析可能有助于临床评估心肌机械不同步。
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