Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
J Magn Reson Imaging. 2018 Oct;48(4):1139-1146. doi: 10.1002/jmri.26016. Epub 2018 Mar 30.
Previous studies have shown that diffusion-weighted imaging (DWI) is sensitive to myocardial fibrosis in ischemic and nonischemic cardiomyopathy.
To explore the prognostic value of apparent diffusion coefficient (ADC) for detecting myocardial fibrosis and its relationship to the contractile function in hypertrophic cardiomyopathy (HCM).
Prospective.
A total of 45 HCM patients and 20 controls.
FIELD STRENGTH/SEQUENCE: 3.0T cardiac MRI. The cardiac MR sequences included cine, T mapping, and DWI.
According to the presence of late gadolinium enhancement (LGE) and the extracellular volume (ECV) values (+2 SD of control subjects), respectively, reader W and reader J assessed the value of ADC of each segment for detecting myocardial fibrosis and its relationship to impaired contractile function in HCM patients.
Independent sample t-test, Pearson analysis, and intraclass correlation (ICC).
The value of ECV was 23.6 ± 3.0% for control. ECV ≥ 29.6% and ECV < 29.6% groups were classified. ADC values in the ECV ≥ 29.6% group were significantly increased compared to the ECV < 29.6% group, (2.41 ± 0.23 μm /ms vs. 2.03 ± 0.16 μm /ms, P < 0.005). Compared to the LGE - group, ECV (32.1 ± 2.3% vs. 29.0 ± 2.8%, P < 0.005) and ADC (2.60 ± 0.18 μm /ms vs. 2.10 ± 0.07 μm /ms, P < 0.005) values were significantly increased in the LGE + group. ADC values were linearly associated with ECV values (R = 0.65) in HCM patients. ADC values were linearly associated with circumferential and longitudinal strain (R = 0.60, R = 0.46), as well as circumferential, longitudinal, and radial strain rate (R = 0.13, R = 0.25, R = 0.17, respectively).
Contractile dysfunction in HCM is predominantly associated with ADC, which is a feasible alternative to ECV and LGE for detecting myocardial fibrosis.
1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1139-1146.
先前的研究表明，弥散加权成像（DWI）对缺血性和非缺血性心肌病中的心肌纤维化敏感。
探讨表观弥散系数（ADC）在检测肥厚型心肌病（HCM）心肌纤维化中的预后价值及其与收缩功能的关系。
前瞻性。
共 45 例 HCM 患者和 20 例对照。
磁场强度/序列：3.0T 心脏 MRI。心脏 MRI 序列包括电影、T 映射和 DWI。
根据有无延迟钆增强（LGE）和细胞外容积（ECV）值（对照组的+2SD），读者 W 和读者 J 评估每个节段 ADC 值对 HCM 患者心肌纤维化的检测价值及其与收缩功能障碍的关系。
独立样本 t 检验、Pearson 分析和组内相关系数（ICC）。
对照组的 ECV 值为 23.6±3.0%。将 ECV≥29.6%和 ECV<29.6%组分类。ECV≥29.6%组的 ADC 值明显高于 ECV<29.6%组，（2.41±0.23μm/ms 比 2.03±0.16μm/ms，P<0.005）。与 LGE-组相比，ECV（32.1±2.3%比 29.0±2.8%，P<0.005）和 ADC（2.60±0.18μm/ms 比 2.10±0.07μm/ms，P<0.005）值在 LGE+组中显著升高。HCM 患者的 ADC 值与 ECV 值呈线性相关（R=0.65）。ADC 值与周向和纵向应变（R=0.60，R=0.46）以及周向、纵向和径向应变率（R=0.13，R=0.25，R=0.17）呈线性相关。
HCM 中的收缩功能障碍主要与 ADC 相关，ADC 是检测心肌纤维化的 ECV 和 LGE 的可行替代方法。
1 技术功效：阶段 2 J. Magn. Reson. Imaging 2018;48:1139-1146.
