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特征追踪心血管磁共振检测梗死节段的诊断能力:与标记磁共振及室壁增厚分析的比较

Diagnostic capability of feature-tracking cardiovascular magnetic resonance to detect infarcted segments: a comparison with tagged magnetic resonance and wall thickening analysis.

作者信息

Ogawa R, Kido T, Nakamura M, Kido T, Kurata A, Miyagawa M, Mochizuki T

机构信息

Department of Radiology, Ehime University Graduate School of Medicine, Toon-city, Ehime 791-0295, Japan.

Department of Radiology, Ehime University Graduate School of Medicine, Toon-city, Ehime 791-0295, Japan.

出版信息

Clin Radiol. 2017 Oct;72(10):828-834. doi: 10.1016/j.crad.2017.05.010. Epub 2017 Jun 12.

Abstract

AIM

To examine the diagnostic capabilities of feature-tracking cardiovascular magnetic resonance (FT-CMR), tagged cine magnetic resonance (MR), and wall thickening (WT) analyses to detect infarcted segments in patients with established myocardial infarction (MI).

MATERIALS AND METHODS

Twenty patients with established MI were selected retrospectively and the peak endocardial circumferential strain (CS) was quantified based on the 16-segment model. According to CMR with late gadolinium enhancement, segments were categorised as transmural MI, subendocardial MI, and no MI.

RESULTS

A total of 320 segments (62 transmural MI, 50 subendocardial MI, and 208 no MI) were analysed. Peak endocardial CS was significantly lower for transmural MI compared with subendocardial MI (p<0.05) and no MI (p<0.001). Cut-off values of -11.2% for CS by FTCMR, -10.9% for CS by tagged MR, and 23.8% for %WT, differentiated between infarcted and non-infarcted segments with a sensitivity of 72%, 71%, and 56%; specificity of 71%, 75%, and 67%; accuracy of 72%, 73%, and 63%; positive predictive value of 57%, 60%, and 48%; negative predictive value of 83%, 83%, and 74%; and an area-under-the-curve of 0.77, 0.79, and 0.64, respectively.

CONCLUSIONS

FT-CMR was diagnostically superior to %WT, and could differentiate between subendocardial and transmural MI. Unlike tagged MR, FT-CMR did not require the acquisition of additional sequences.

摘要

目的

研究特征追踪心血管磁共振成像(FT-CMR)、标记电影磁共振成像(MR)及室壁增厚(WT)分析在已确诊心肌梗死(MI)患者中检测梗死节段的诊断能力。

材料与方法

回顾性选取20例已确诊MI的患者,基于16节段模型对心内膜圆周应变峰值(CS)进行量化。根据延迟钆增强磁共振成像,将节段分为透壁性心肌梗死、心内膜下心肌梗死及无心肌梗死。

结果

共分析320个节段(62个透壁性心肌梗死节段、50个心内膜下心肌梗死节段及208个无心肌梗死节段)。透壁性心肌梗死的心内膜CS峰值显著低于心内膜下心肌梗死(p<0.05)及无心肌梗死节段(p<0.001)。FT-CMR测量的CS截断值为-11.2%,标记MR测量的CS截断值为-10.9%,WT百分比截断值为23.8%,这些截断值区分梗死节段与非梗死节段的敏感度分别为72%、71%和56%;特异度分别为71%、75%和67%;准确度分别为72%、73%和63%;阳性预测值分别为57%、60%和48%;阴性预测值分别为83%、83%和74%;曲线下面积分别为0.77、0.79和0.64。

结论

FT-CMR在诊断方面优于WT百分比,且能区分心内膜下心肌梗死与透壁性心肌梗死。与标记MR不同,FT-CMR无需采集额外序列。

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