Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milano, Italy.
Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milano, Italy.
Eur Radiol Exp. 2023 Feb 24;7(1):9. doi: 10.1186/s41747-023-00322-3.
Our purpose was to evaluate the correlations between right ventricular (RV) late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) in patients with tetralogy of Fallot (ToF) scheduled for pulmonary valve replacement (PVR) and post-PVR functional data.
We retrospectively reviewed ToF patients scheduled for PVR who underwent two CMR examinations at our institution, one before the procedure (CMR-0), including contrast-enhanced sequences, and one after the procedure (CMR-1). Functional left and RV data were obtained by segmenting short-axis stacks on both CMR examinations, and normalised variations were calculated by dividing differences between CMR-1 and CMR-0 by the intercurring time interval, whereas the RV scar burden was assessed on CMR-0 LGE sequences both semiquantitatively and quantitatively. Data were reported as median and interquartile range, differences were appraised with the Mann-Whitney U test, while correlations were assessed with Spearman's ρ.
Fifteen patients with a median age of 25 years (16-29), including 9 (60%) males, with a median time interval between CMR-0 and CMR-1 of 17 months (12-23), were retrospectively reviewed. The semiquantitative LGE score at CMR-0 was 7 (6-9), and LGE volume was 4.49 mL (3.70-5.78), covering 5.63% (4.92-7.00) of the RV. RV LGE score showed a moderate positive correlation with the normalised variation of RV stroke volume (ρ = 0.662, p = 0.007) and a borderline moderate positive correlation with the normalised variation of RV end-diastolic indexed volume (ρ = 0.513, p = 0.050).
The assessment of RV LGE before PVR may provide insights on post-PVR functional data, potentially facilitating a patient-tailored treatment pathway.
本研究旨在评估行肺动脉瓣置换术（PVR）的法洛四联症（ToF）患者心脏磁共振（CMR）检查中右心室（RV）延迟钆增强（LGE）与术后功能数据之间的相关性。
我们回顾性分析了在我院行两次 CMR 检查的计划行 PVR 的 ToF 患者，一次为术前（CMR-0），包括对比增强序列，一次为术后（CMR-1）。通过对两次 CMR 短轴堆栈进行分段，获得左室和 RV 功能数据，并通过将 CMR-1 与 CMR-0 之间的差值除以时间间隔来计算正常化变化，而 RV 瘢痕负荷则通过 CMR-0 LGE 序列进行半定量和定量评估。数据以中位数和四分位间距表示，采用 Mann-Whitney U 检验评估差异，采用 Spearman ρ 检验评估相关性。
回顾性分析了 15 例中位年龄为 25 岁（16-29 岁）的患者，其中男性 9 例（60%），CMR-0 与 CMR-1 之间的中位时间间隔为 17 个月（12-23 个月）。CMR-0 的 LGE 评分中位数为 7（6-9），LGE 体积为 4.49mL（3.70-5.78），占 RV 的 5.63%（4.92-7.00）。RV LGE 评分与 RV 收缩期容积的正常化变化呈中度正相关（ρ=0.662，p=0.007），与 RV 舒张末期指数容积的正常化变化呈中度正相关（ρ=0.513，p=0.050）。
PVR 前 RV LGE 的评估可能为术后功能数据提供一些见解，有助于制定个体化的治疗方案。
