心脏磁共振特征追踪：一种评估慢性心肌梗死后左心室三维应变力学的新方法。
Cardiac Magnetic Resonance Feature Tracking: A Novel Method to Assess Left Ventricular Three-Dimensional Strain Mechanics After Chronic Myocardial Infarction.
机构信息
PET-CT/MR Department, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China.
Medical imaging Department, the 4th Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
出版信息
Acad Radiol. 2021 May;28(5):619-627. doi: 10.1016/j.acra.2020.03.013. Epub 2020 Apr 24.
RATIONALE AND OBJECTIVES
This study was designed to assess left ventricular deformation after chronic myocardial infarction (CMI) using cardiac magnetic resonance feature tracking (CMR-FT) technology, and analyze its relationship with left ventricular ejection fraction (LVEF) and infarcted transmurality.
MATERIALS AND METHODS
Ninety-six patients with CMI and 72 controls underwent 3.0 T CMR scanning. Strain parameters were measured by dedicated software, including global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS), segmental peak longitudinal strain (PLS), peak circumferential strain (PCS), and peak radial strain (PRS). All enhanced myocardium segments were divided into subendocardial infarction (SI) and transmural infarction (TI) group. Pearson, intraclass correlation coefficient and receiver operating characteristic analysis were performed to compare the parameters' mean values between SI and TI groups.
RESULTS
GPLS, GPRS, and GPCS in CMI group were significantly decreased comparing with control group. PRS and PCS in TI group were significantly lower than those in SI group, whereas no statistical difference was observed in PLS. In Pearson correlation analysis, LVEF was strongly correlated with GPLS, GPRS, and GPCS in CMI patients. Additionally, excellent reproducibility of all strain parameters was observed. In receiver operating characteristic analysis, segmental PRS and PCS might differentiate SI from TI with higher diagnostic efficiency (p < 0.05), while PLS was less valuable (p > 0.05).
CONCLUSION
CMR-FT could noninvasively and quantitatively assess global and regional myocardial strain in CMI patients with excellent reproducibility and strong correlation with LVEF. Additionally, segmental myocardial strain parameters indicate potential clinical value in differentiating myocardial infarction subtype.
背景与目的
本研究旨在利用心脏磁共振特征追踪（CMR-FT）技术评估慢性心肌梗死（CMI）后左心室变形，并分析其与左心室射血分数（LVEF）和梗死透壁程度的关系。
材料与方法
96 例 CMI 患者和 72 例对照者接受 3.0T CMR 扫描。使用专用软件测量应变参数，包括整体峰值纵向应变（GPLS）、整体峰值周向应变（GPCS）、整体峰值径向应变（GPRS）、节段峰值纵向应变（PLS）、峰值周向应变（PCS）和峰值径向应变（PRS）。所有增强心肌节段分为心内膜下梗死（SI）和透壁梗死（TI）组。采用 Pearson、组内相关系数和受试者工作特征分析比较 SI 和 TI 组参数的平均值。
结果
与对照组相比，CMI 组的 GPLS、GPRS 和 GPCS 显著降低。TI 组的 PRS 和 PCS 明显低于 SI 组，而 PLS 无统计学差异。在 Pearson 相关分析中，LVEF 与 CMI 患者的 GPLS、GPRS 和 GPCS 呈强相关。此外，所有应变参数均具有良好的可重复性。在受试者工作特征分析中，节段性 PRS 和 PCS 可能具有较高的诊断效率（p<0.05），可区分 SI 与 TI，而 PLS 价值较低（p>0.05）。
结论
CMR-FT 可无创、定量评估 CMI 患者的整体和局部心肌应变，具有良好的可重复性，与 LVEF 有较强的相关性。此外，节段心肌应变参数在区分心肌梗死亚型方面具有潜在的临床价值。
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