Del-Canto Irene, López-Lereu María P, Monmeneu José V, Croisille Pierre, Clarysse Patrick, Chorro Francisco J, Bodí Vicente, Moratal David
Fundación de Investigación del Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, Spain.
J Magn Reson Imaging. 2015 Jan;41(1):83-92. doi: 10.1002/jmri.24539. Epub 2013 Dec 12.
The aim of this study was to establish reference values for segmental myocardial strain measured by magnetic resonance (MR) cardiac tagging in order to characterize the regional function of the heart.
We characterized the left ventricular (LV) systolic deformation in 39 subjects (26 women and 13 men, age 58.8 ± 11.6 years) whose cardiological study had not revealed any significant abnormality. The deformation was measured from MR-tagged (Siemens 1.5T MR) images using an algorithm based on sine wave modeling. Circumferential and radial peak systolic strain values along with the torsion angle and circumferential-longitudinal (CL) shear were determined in 16 LV segments in order to settle the reference values for these parameters.
Circumferential strain was highest at the anterior and lateral walls (-20.2 ± 4.0% and -21.8 ± 4.3%, respectively; P < 0.05) and was lowest at the base level (-17.2 ± 3.1% vs. -20.1 ± 3.1% "mid level," P < 0.05; -17.2 ± 3.1% vs. -20.3 ± 3.0% "apical level," P < 0.05). Radial strain highest values were from inferior and lateral walls (13.7 ± 7.4% and 12.8 ± 7.8%, respectively; P < 0.05) and it was lowest medially (9.4 ± 4.1% vs. 13.1 ± 4.1% "base level," P < 0.05; 9.4 ± 4.1% vs. 12.1 ± 4.4% "apical level," P < 0.05). Torsion angle (counterclockwise when viewed from the apex) increased with the distance from the base (7.9 ± 2.4° vs. 16.8 ± 4.4°, P < 0.05), and the highest and lowest values were found at lateral (medial lateral: 12.0 ± 4.4°, apical lateral: 25.1 ± 6.4°, P < 0.05) and septal wall (medial septal: 3.6 ± 2.1°, apical septal: 8.3 ± 5.3°, P < 0.05), respectively. These differences were found again in CL shear values, around the LV circumference. However, CL shear remained constant with increasing distance from the base (9.1 ± 2.6°, medium and 9.8 ± 2.4°, apex).
In summary, this study provides reference values for the assessment of regional myocardial function by MR cardiac tagging. Comparison of patient deformation parameters with normal deformation patterns may permit early detection of regional systolic dysfunction.
本研究旨在建立通过磁共振(MR)心脏标记测量节段性心肌应变的参考值,以表征心脏的区域功能。
我们对39名受试者(26名女性和13名男性,年龄58.8±11.6岁)的左心室(LV)收缩期变形进行了表征,这些受试者的心脏病学检查未发现任何显著异常。使用基于正弦波建模的算法从MR标记(西门子1.5T MR)图像测量变形。在16个LV节段中确定圆周和径向收缩期峰值应变值以及扭转角和圆周-纵向(CL)剪切,以确定这些参数的参考值。
圆周应变在前壁和侧壁最高(分别为-20.2±4.0%和-21.8±4.3%;P<0.05),在基底部最低(-17.2±3.1%对-20.1±3.1%“中层”,P<0.05;-17.2±3.1%对-20.3±3.0%“心尖层”,P<0.05)。径向应变最高值来自下壁和侧壁(分别为13.7±7.4%和12.8±7.8%;P<0.05),在内侧最低(9.4±4.1%对13.1±4.1%“基底部”,P<0.05;9.4±4.1%对12.1±4.4%“心尖层”,P<0.05)。扭转角(从心尖看为逆时针方向)随着与基底部距离的增加而增加(7.9±2.4°对16.8±4.4°,P<0.05),最高和最低值分别在侧壁(内侧侧壁:12.0±4.4°,心尖侧壁:25.1±6.4°,P<0.05)和室间隔壁(内侧室间隔:3.6±2.1°,心尖室间隔:8.3±5.3°,P<0.05)发现。在LV圆周周围的CL剪切值中再次发现这些差异。然而,CL剪切随着与基底部距离的增加保持恒定(中层为9.1±2.6°,心尖为9.8±2.4°)。
总之,本研究为通过MR心脏标记评估区域心肌功能提供了参考值。将患者的变形参数与正常变形模式进行比较可能有助于早期检测区域收缩功能障碍。