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心脏磁共振特征追踪技术在孤立性左心室心肌致密化不全与扩张型心肌病鉴别诊断中的价值

Value of cardiac magnetic resonance feature tracking technology in the differential diagnosis of isolated left ventricular noncompaction and dilated cardiomyopathy.

作者信息

Zhu Lina, Wu Jiang, Hao Xiaoyong, Li Xuan

机构信息

Department of Magnetic Resonance, Shanxi Cardiovascular Hospital, Taiyuan, China.

出版信息

Quant Imaging Med Surg. 2023 Mar 1;13(3):1453-1463. doi: 10.21037/qims-22-710. Epub 2023 Feb 6.

Abstract

BACKGROUND

This study explored the value of myocardial strain in the differential diagnosis of isolated left ventricular myocardial noncompaction (ILVNC) and dilated cardiomyopathy (DCM) using cardiac magnetic resonance (CMR) feature tracking technology.

METHODS

This retrospective analysis was performed on consecutive patients (25 with ILVNC, 30 with DCM, and 30 healthy controls) presenting to Shanxi Cardiovascular Hospital. All ILVNC patients met echocardiographic and CMR criteria for ventricular non-compaction. All patients with DCM met the 2016 American Heart Association and 2018 Chinese Medical Association Cardiovascular Branch diagnostic criteria. cvi42 software (Circle Cardiovascular Imaging) was used to measure radial, circumferential, and longitudinal strain (LS) globally and in segments of the left ventricle. Analysis of variance was used to compare strains among groups and among different segments within the same group. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of different parameters in ILVNC and DCM.

RESULTS

Basal circumferential strain was lower in the DCM than in the ILVNC group (P=0.05). Both median and apical LS were lower in the ILVNC than in DCM group (P=0.02 and P=0.01, respectively). ROC curves showed that apical LS was the most effective in distinguishing ILVNC from DCM [area under the curve (AUC) =0.883; P<0.001; 95% CI: 0.850-0.977]. Comparing strains among different segments within the same group revealed that in DCM, the circumferential and LS of the apex were higher than those of the basal segment, which is consistent with the pattern in healthy controls; however, has no such regular pattern was seen in ILVNC.

CONCLUSIONS

Myocardial strain parameters are of considerable value in the differential diagnosis of ILVNC and DCM. Differences in patterns between ILVNC and DCM can be sensitively identified, providing more comprehensive information for early clinical diagnosis.

摘要

背景

本研究利用心脏磁共振(CMR)特征追踪技术探讨心肌应变在孤立性左心室心肌致密化不全(ILVNC)与扩张型心肌病(DCM)鉴别诊断中的价值。

方法

对山西心血管病医院连续收治的患者进行回顾性分析(25例ILVNC患者、30例DCM患者和30例健康对照)。所有ILVNC患者均符合超声心动图和CMR心室非致密化标准。所有DCM患者均符合2016年美国心脏协会和2018年中华医学会心血管病分会诊断标准。使用cvi42软件(Circle Cardiovascular Imaging)测量左心室整体及节段的径向、圆周和纵向应变(LS)。采用方差分析比较组间及同组不同节段的应变。采用受试者工作特征(ROC)曲线评估不同参数对ILVNC和DCM的诊断效能。

结果

DCM组基底圆周应变低于ILVNC组(P = 0.05)。ILVNC组的中位LS和心尖LS均低于DCM组(分别为P = 0.02和P = 0.01)。ROC曲线显示,心尖LS在区分ILVNC和DCM方面最有效[曲线下面积(AUC)= 0.883;P < 0.001;95% CI:0.850 - 0.977]。比较同组不同节段的应变发现,在DCM中,心尖的圆周应变和LS高于基底节段,这与健康对照的模式一致;然而,ILVNC中未观察到这种规律模式。

结论

心肌应变参数在ILVNC和DCM的鉴别诊断中具有重要价值。可以敏感地识别ILVNC和DCM之间模式的差异,为临床早期诊断提供更全面的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27fb/10006129/08d116c38348/qims-13-03-1453-f1.jpg

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