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心脏磁共振成像的原生T1映射技术对左心室心肌致密化不全患者致密心肌异常的特征分析——与延迟钆增强的比较

Characterization of Compacted Myocardial Abnormalities by Cardiac Magnetic Resonance With Native T1 Mapping in Left Ventricular Non-Compaction Patients - A Comparison With Late Gadolinium Enhancement.

作者信息

Zhou Hongmei, Lin Xue, Fang Ligang, Zhao Xihai, Ding Haiyan, Chen Wei, Xu Ruiyi, Bai Xiaoyin, Wang Yining, Fang Quan

机构信息

Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.

出版信息

Circ J. 2016 Apr 25;80(5):1210-6. doi: 10.1253/circj.CJ-15-1269. Epub 2016 Mar 23.

Abstract

BACKGROUND

Native T1 mapping is an emerging cardiac magnetic resonance technique for quantitative evaluation of cardiomyopathies. This study aimed to investigate the usefulness of native T1 mapping in characterizing myocardial abnormalities in left ventricular non-compaction (LVNC) by comparing it with late gadolinium enhancement (LGE).

METHODS AND RESULTS

The study group of 31 LVNC patients and 8 normal controls underwent cardiovascular magnetic resonance to acquire the native T1 maps and LGE images. Of the 31 LVNC patients, 14 had LGE. The mean native T1 value of the normal controls, LGE(-) and LGE(+) patients was 1,098.8±40.8 ms, 1140.6±32.8 ms, and 1181.4±53.7 ms, respectively. Significant differences were found in native T1 between any 2 groups (F=9.74, P<0.001). In discriminating the presence of LGE in LVNC patients, the odds ratio and corresponding 95% confidence interval (CI) of native T1 were, respectively, 2.966 (95% CI: 1.123-7.835, P=0.028) and 4.348 (95% CI: 1.155-16.363, P=0.030) before and after adjusting for confounding factors with an increment of 1 standard deviation.

CONCLUSIONS

The finding that LGE(-) patients had elevated native T1 compared with normal controls suggested native T1 mapping can be used earlier than LGE imaging to detect myocardial fibrosis in LVNC patients. Furthermore, higher native T1 values in LGE(+) patients than in the LGE(-) group suggested native T1 mapping is more sensitive than LGE imaging for identifying myocardial fibrosis in LVNC patients. (Circ J 2016; 80: 1210-1216).

摘要

背景

自然T1 mapping是一种新兴的心脏磁共振技术,用于心肌病的定量评估。本研究旨在通过将自然T1 mapping与延迟钆增强(LGE)进行比较,探讨其在表征左心室心肌致密化不全(LVNC)心肌异常中的作用。

方法与结果

31例LVNC患者和8名正常对照组成的研究组接受了心血管磁共振检查,以获取自然T1图和LGE图像。31例LVNC患者中,14例有LGE。正常对照组、LGE(-)和LGE(+)患者的平均自然T1值分别为1098.8±40.8 ms、1140.6±32.8 ms和1181.4±53.7 ms。任意两组之间的自然T1均存在显著差异(F=9.74,P<0.001)。在区分LVNC患者是否存在LGE时,校正混杂因素后,自然T1的优势比及相应的95%置信区间(CI)在自然T1值增加1个标准差前后分别为2.966(95%CI:1.123-7.835,P=0.028)和4.348(95%CI:1.155-16.363,P=0.030)。

结论

LGE(-)患者的自然T1值高于正常对照组,这一发现表明自然T1 mapping比LGE成像能更早地检测LVNC患者的心肌纤维化。此外,LGE(+)患者的自然T1值高于LGE(-)组,提示自然T1 mapping在识别LVNC患者心肌纤维化方面比LGE成像更敏感。(《循环杂志》2016年;80:1210-1216)

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