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应用位移编码的刺激回波 MRI 对冠心病患者心肌应变的定量评估。

Quantitative assessment of myocardial strain with displacement encoding with stimulated echoes MRI in patients with coronary artery disease.

机构信息

Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.

出版信息

Int J Cardiovasc Imaging. 2013 Dec;29(8):1779-86. doi: 10.1007/s10554-013-0274-y. Epub 2013 Aug 10.

Abstract

To determine the diagnostic performance and reproducibility of strain assessment with displacement encoding with stimulated echoes (DENSE) cardiovascular magnetic resonance (CMR) in identifying contractile abnormalities in myocardial segments with late gadolinium enhancement (LGE). DENSE CMR was obtained on short-axis planes of the left ventricle (LV) in 24 patients with suspected coronary artery disease. e1 and e2 strains of LV wall were quantified. Cine MRI was acquired to determine percent systolic wall thickening (%SWT), followed by (LGE) CMR. The diagnostic performance of e1, e2 and %SWT for predicting the presence of LGE was evaluated by receiver operating characteristics (ROC) analysis. Myocardial scar on LGE CMR was observed in 91 (24 %) of 384 segments. The area under ROC curve for predicting the segments with LGE was 0.874 by e1, 0.916 by e2 and 0.828 by %SWT (p = 0.001 between e2 and %SWT). Excellent inter-observer reproducibility was found for strain [Intraclass correlation coefficient (ICC) = 0.962 for e1, 0.955 for e2] as compared with %SWT (ICC = 0.790). DENSE CMR can be performed as a part of routine CMR study and allows for quantification of myocardial strain with high inter-observer reproducibility. Myocardial strain, especially e2 is useful in detecting altered abnormal systolic contraction in the segments with myocardial scar.

摘要

目的

评估基于位移编码的刺激回波(DENSE)心血管磁共振(CMR)技术评估应变的诊断性能和可重复性,以识别伴有延迟钆增强(LGE)的心肌节段的收缩异常。

方法

对 24 例疑诊冠心病患者的左心室(LV)短轴层面进行 DENSE CMR 检查,量化 LV 壁的 e1 和 e2 应变。获取电影 MRI 以确定收缩期壁增厚百分比(%SWT),随后进行 LGE CMR。通过受试者工作特征(ROC)分析评估 e1、e2 和 %SWT 预测 LGE 存在的诊断性能。

结果

在 384 个节段中,91 个(24%)观察到 LGE 心肌瘢痕。e1 预测存在 LGE 节段的 ROC 曲线下面积为 0.874,e2 为 0.916,%SWT 为 0.828(e2 与 %SWT 之间的 p = 0.001)。与 %SWT(ICC = 0.790)相比,应变的观察者间可重复性良好[e1 的 ICC = 0.962,e2 的 ICC = 0.955]。

结论

DENSE CMR 可作为常规 CMR 研究的一部分,可实现心肌应变的定量评估,且具有较高的观察者间可重复性。应变,尤其是 e2,有助于检测伴有心肌瘢痕的节段中收缩异常。

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