Cau Riccardo, Bassareo Pierpaolo, Deidda Martino, Caredda Gloria, Suri Jasjit S, Pontone Gianluca, Saba Luca
Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, ITALY.
University College of Dublin, Mater Misericordiae University Hospital and Our Lady's Children's Hospital, Dublin, Republic of Ireland.
Acad Radiol. 2022 Apr;29 Suppl 4:S33-S39. doi: 10.1016/j.acra.2021.01.009. Epub 2021 Jan 22.
Takotsubo syndrome (TS) is a transient and often misdiagnosed form of left ventricular dysfunction. Acute myocarditis (AM) is usually included in TS differential diagnosis. The aim of this study is to assess the role of cardiac magnetic resonance imaging coupled with tissue-tracking technique (CMR-TT) and parametric mappings analysis in discriminating between TS and AM.
We retrospectively enrolled three groups: patients with TS (n = 12), patients with AM (n = 14), and 10 healthy controls. All the patients had a comprehensive CMR examination, including the assessment of global and segmental longitudinal strain, circumferential strain, radial strain (RS), and parametric mapping.
The analysis of variance was used to compare the different groups. In TS patients, basal RS, global T1 mapping, global T2 mapping, mid T2 mapping, apical T1 and T2 mapping were statistically significantly different compared with the other groups. MANCOVA analysis confirmed that the association between myocardial strain data and parametric mapping was independent on age and sex. Apical T1 and T2 mapping proved to have a good performance in differentiating TS from AM (area under the curves of 0.908 and 0.879, respectively).
Basal RS and apical tissue mapping analysis are the most advanced CMR-derived parameters in making a differential diagnosis between TS and AM.
Takotsubo综合征（TS）是一种左心室功能障碍的短暂且常被误诊的形式。急性心肌炎（AM）通常包含在TS的鉴别诊断中。本研究的目的是评估心脏磁共振成像结合组织追踪技术（CMR-TT）和参数映射分析在鉴别TS和AM中的作用。
我们回顾性纳入了三组：TS患者（n = 12）、AM患者（n = 14）和10名健康对照者。所有患者均接受了全面的CMR检查，包括整体和节段性纵向应变、圆周应变、径向应变（RS）以及参数映射的评估。
采用方差分析比较不同组。在TS患者中，与其他组相比，基底RS、整体T1映射、整体T2映射、中间T2映射、心尖T1和T2映射在统计学上有显著差异。多变量协方差分析证实心肌应变数据与参数映射之间的关联独立于年龄和性别。心尖T1和T2映射在区分TS和AM方面表现良好（曲线下面积分别为0.908和0.879）。
基底RS和心尖组织映射分析是CMR衍生的在鉴别TS和AM方面最先进的参数。
