Pandey Tarun, Alapati Sindhura, Wadhwa Vibhor, Edupuganti Mohan M, Gurram Pooja, Lensing Shelly, Jambhekar Kedar
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.
Curr Probl Diagn Radiol. 2017 Jul-Aug;46(4):288-294. doi: 10.1067/j.cpradiol.2016.11.008. Epub 2016 Nov 10.
To study the use of cardiac magnetic resonance (CMR) feature tracking technique in evaluation of myocardial amyloidosis.
CMR scans of 28 patients with biopsy proven myocardial amyloidosis and 35 controls were reviewed. Conventional short axis, vertical long axis, and 4-chamber cine steady-state free precession images from CMR scans were used to generate radial, circumferential, and longitudinal myocardial strain maps using feature tracking software. Global and regional peak radial, circumferential, and longitudinal strain values were computed.
There were significant decreases in radial, circumferential, and longitudinal strains in patients with myocardial amyloidosis globally and across layers (all P < 0.001). Strain was relatively preserved for the apex and most affected for the basal level. The area under the receiver operating characteristic curve for base peak radial, circumferential, and longitudinal strain 0.899, 0.884, and 0.866 and cut offs of 22.9, -13.3, and -10.9, respectively, were determined by receiver operating characteristic analysis. CMR feature tracking strain analysis of base-level strain parameters was able to differentiate patients with myocardial amyloidosis from those without myocardial amyloid with high sensitivity (82.5%) and specificity (82.9%) particularly for radial strain. The maximum sensitivity (89.3%) was achieved if any of the 3 parameters were abnormal, and the maximum specificity (88.6%) when all 3 parameters were abnormal.
Myocardial amyloidosis produces significant changes in regional and global strain parameters, and the peak radial and circumferential strain are the most affected at the basal layer.
研究心脏磁共振（CMR）特征追踪技术在评估心肌淀粉样变性中的应用。
回顾性分析28例经活检证实为心肌淀粉样变性患者及35例对照者的CMR扫描图像。利用CMR扫描获得的常规短轴、垂直长轴和四腔心电影稳态自由进动图像，通过特征追踪软件生成径向、圆周和纵向心肌应变图。计算整体和局部的径向、圆周和纵向峰值应变值。
心肌淀粉样变性患者的整体及各层径向、圆周和纵向应变均显著降低（均P < 0.001）。心尖部应变相对保留，基底部受影响最大。通过受试者工作特征分析，确定基底部峰值径向、圆周和纵向应变的受试者工作特征曲线下面积分别为0.899、0.884和0.866，截断值分别为22.9%、-13.3%和-10.9%。基底部应变参数的CMR特征追踪应变分析能够以高灵敏度（82.5%）和特异性（82.9%）区分心肌淀粉样变性患者和非心肌淀粉样变性患者，尤其是对于径向应变。如果3个参数中的任何一个异常，最大灵敏度为89.3%；如果所有3个参数都异常，最大特异性为88.6%。
心肌淀粉样变性会导致局部和整体应变参数发生显著变化，基底部的径向和圆周峰值应变受影响最大。
