Parekh Keyur, Markl Michael, Deng Jie, de Freitas Roger A, Rigsby Cynthia K
Department of Medical Imaging, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Chicago, IL, 60611, USA.
Department of Radiology, Feinberg School of Medicine, Northwestern University, 225 East Chicago Avenue, Chicago, IL, 60611, USA.
Int J Cardiovasc Imaging. 2017 Jan;33(1):109-117. doi: 10.1007/s10554-016-0979-9. Epub 2016 Sep 22.
To assess the global and segmental left ventricular (LV) native T1 and extracellular volume fraction (ECV) in children and young adults with hypertrophic cardiomyopathy (HCM) compared to a control cohort. The study population included 21 HCM patients (mean 14.1 ± 4.6 years) and 21 controls (mean 15.7 ± 1.5 years). Native modified Look-Locker inversion recovery sequence was performed before and after contrast injection in 3 short axis planes. Global and segmental LV native T1 and ECV were quantified and compared between HCM patients and controls. Mean native T1 in HCM patients and controls was 1020.4 ± 41.2 and 965.6 ± 30.2 ms respectively (p < 0.0001). Hypertrophied myocardium had significantly higher native global T1 and global ECV compared to non-hypertrophied myocardium in HCM (p < 0.0001, = 0.14 and 0.048, = 0.01 respectively). In a subset of patients, ECV was higher in LV segments with LGE compared to no LGE (p < 0.0001). No significant correlation was identified between global native T1 and ECV and parameters of LV structure and function. Native T1 cut-off of 987 ms provided the highest sensitivity (95 %) and specificity (91 %) to separate HCM patients from controls. Global and segmental native T1 are elevated in HCM patients. LV segments with hypertrophy and/or LGE had higher ECV in a subset of HCM patients. LV native T1 and ECV do not correlate with parameters of LV structure and function. T1 in children and young adults may be used as a non-invasive tool to assess for HCM and related fibrosis.
为评估肥厚型心肌病（HCM）患儿及青年人与对照组相比左心室（LV）整体及节段性的固有T1和细胞外容积分数（ECV）。研究人群包括21例HCM患者（平均14.1±4.6岁）和21名对照组（平均15.7±1.5岁）。在3个短轴平面上于注射造影剂前后进行固有改良Look-Locker反转恢复序列检查。对HCM患者和对照组的左心室整体及节段性固有T1和ECV进行定量并比较。HCM患者和对照组的平均固有T1分别为1020.4±41.2和965.6±30.2毫秒（p<0.0001）。与HCM中未肥厚的心肌相比，肥厚心肌的固有整体T1和整体ECV显著更高（p<0.0001，分别为0.14和0.048，0.01）。在一部分患者中，有心肌梗死延迟增强（LGE）的左心室节段的ECV高于无LGE的节段（p<0.0001）。未发现整体固有T1和ECV与左心室结构和功能参数之间存在显著相关性。987毫秒的固有T1临界值在区分HCM患者与对照组时具有最高的敏感性（95%）和特异性（91%）。HCM患者的整体及节段性固有T1升高。在一部分HCM患者中，有肥厚和/或LGE的左心室节段具有更高的ECV。左心室固有T1和ECV与左心室结构和功能参数无关。儿童和青年的T1可用作评估HCM及相关纤维化的非侵入性工具。
