通过映射和应变心脏磁共振成像进行组织特征分析以评估暴发性心肌炎中的心肌炎症
Tissue Characterization by Mapping and Strain Cardiac MRI to Evaluate Myocardial Inflammation in Fulminant Myocarditis.
作者信息
Li Haojie, Zhu Hui, Yang Zhaoxia, Tang Dazhong, Huang Lu, Xia Liming
机构信息
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
J Magn Reson Imaging. 2020 Sep;52(3):930-938. doi: 10.1002/jmri.27094. Epub 2020 Feb 20.
BACKGROUND
The clinical value of novel mapping techniques and strain measures to assess myocardial inflammation in fulminant myocarditis (FM) has not been fully explored.
PURPOSE
To evaluate the ability of mapping and strain cardiac MRI to assess myocardial inflammation in patients with FM, and to which degree the strain metrics correlate with myocardial edema.
STUDY TYPE
Prospective.
POPULATION
Twenty-nine patients (37 ± 16 years, 48% male) with FM and 29 patients with nonfulminant acute myocarditis (NFAM) (29 ± 14 years, 69% male).
FIELD STRENGTH/SEQUENCE: 3.0T; Cine imaging, black blood T -weighted imaging, T mapping, T mapping, and late gadolinium enhancement.
ASSESSMENT
Native T , extracellular volume (ECV), and T were measured. Myocardial strain was evaluated by feature tracking.
STATISTICAL TESTS
Student's t- or Mann-Whitney U-test. Spearman correlation analysis.
RESULTS
The myocardial edema rate (2.6 ± 0.7 vs. 1.6 ± 0.2, P < 0.001) and late gadolinium enhancement (LGE) mass (16.5 [11.7, 41.7] vs. 6.9 [2.2, 15.8] g, P < 0.001) were significantly increased in FM patients when compared to the NFAM group. LGE in the FM group was predominantly located in the septal wall, and 38% of the patients showed a diffuse LGE pattern. Native T , ECV, and T values in the FM group were significantly more elevated than those with NFAM, while global peak radial, circumferential, and longitudinal strain values were significantly reduced (all P < 0.001). Circumferential strain showed the strongest correlations with ECV (r = 0.72, P < 0.001).
DATA CONCLUSION
Patients with FM showed significant differences in LGE patterns, increased edema, and decreased strain measurements compared to those with NFAM. Circumferential strain showed significant associations with quantitative cardiac MRI parameters of myocardial inflammation.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY STAGE: 2 J. Magn. Reson. Imaging 2020;52:930-938.
背景
新型成像技术和应变测量方法在评估暴发性心肌炎（FM）心肌炎症方面的临床价值尚未得到充分探索。
目的
评估心脏磁共振成像的成像和应变技术评估FM患者心肌炎症的能力，以及应变指标与心肌水肿的相关程度。
研究类型
前瞻性研究。
研究对象
29例FM患者（年龄37±16岁，男性占48%）和29例非暴发性急性心肌炎（NFAM）患者（年龄29±14岁，男性占69%）。
场强/序列：3.0T；电影成像、黑血T加权成像、T成像、T成像和延迟钆增强成像。
评估指标
测量心肌固有T值、细胞外容积（ECV）和T值。采用特征追踪法评估心肌应变。
统计分析
采用Student's t检验或Mann-Whitney U检验。进行Spearman相关性分析。
结果
与NFAM组相比，FM患者的心肌水肿率（2.6±0.7 vs. 1.6±0.2，P<0.001）和延迟钆增强（LGE）质量（16.5[11.7, 41.7]g vs. 6.9[2.2, 15.8]g，P<0.001）显著增加。FM组的LGE主要位于室间隔，38%的患者表现为弥漫性LGE模式。FM组的心肌固有T值、ECV和T值显著高于NFAM组，而整体峰值径向、周向和纵向应变值显著降低（均P<0.001）。周向应变与ECV的相关性最强（r = 0.72，P<0.001）。
数据结论
与NFAM患者相比，FM患者的LGE模式、水肿增加和应变测量值降低存在显著差异。周向应变与心肌炎症的心脏磁共振定量参数显著相关。
证据水平
2级 技术效能阶段：2级 《磁共振成像杂志》2020年；52:930 - 938。
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