磁共振 T2 Mapping 定量评估川崎病患儿心肌水肿。
Quantitative Assessment of Myocardial Edema by MR T2 Mapping in Children With Kawasaki Disease.
机构信息
Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Pediatric Cardiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
出版信息
J Magn Reson Imaging. 2024 Mar;59(3):825-834. doi: 10.1002/jmri.28854. Epub 2023 Jun 20.
BACKGROUND
Few studies assessed myocardial inflammation using Cardiovascular Magnetic Resonance Imaging in Kawasaki disease (KD) patients.
PURPOSE
To quantify myocardial edema in KD patients using T2 mapping and explore the independent predictors of T2 values.
STUDY TYPE
Prospective.
SUBJECTS
Ninety KD patients including 40 in acute phase (26 males, 65.0%) and 50 in chronic phase (34 males, 68.0%). Thirty-one healthy volunteers (21 males, 70.0%).
FIELD STRENGTH/SEQUENCE: 3.0 T T2-weighted Turbo Spin Echo-Short Time of Inversion Recovery sequence, True fast imaging with steady precession flash sequence and fast low-angle shot 3D spoiled gradient echo sequence.
ASSESSMENT
T2 values were compared among KD groups and controls.
STATISTICAL TEST
Student's t test and Fisher's exact test; One-way analysis of variance; Pearson correlation analysis; Receiver operating curve analysis; Multivariable linear regression.
RESULTS
Global T2 value of KD patients in acute phase was the highest, followed by those of chronic-phase patients and controls (38.83 ± 2.41 msec vs. 37.55 ± 2.28 msec vs. 36.05 ± 1.64 msec). Regional T2 values showed a same trend. There were no significant differences in global and regional T2 values between KD patients with and without coronary artery (CA) dilation, no matter in acute or chronic phase (all KD patients: P = 0.51, 0.51, 0.53, 0.72; acute KD: P = 0.61, 0.37, 0.33, 0.83; chronic KD: P = 0.65, 0.79, 0.62, 0.79). No significant difference was observed in global T2 values between KD patients with Z score > 5.0 and 2.0 < Z score ≤ 5.0 (P = 0.65). Multivariate analysis demonstrated that stage of disease (β = -0.123) and heart rate (β = 0.280) were independently associated with global T2 values.
DATA CONCLUSION
The degree of myocardial edema was more severe in acute-phase than in chronic-phase KD patients. Myocardial edema persists in patients regardless of the existence or degree of CA dilation.
EVIDENCE LEVEL
2 TECHNICAL EFFICACY: Stage 2.
背景
很少有研究使用心血管磁共振成像评估川崎病（KD）患者的心肌炎症。
目的
使用 T2 映射定量 KD 患者的心肌水肿，并探讨 T2 值的独立预测因素。
研究类型
前瞻性。
受试者
90 例 KD 患者，包括急性期 40 例（26 名男性，65.0%）和慢性期 50 例（34 名男性，68.0%），31 名健康志愿者（21 名男性，70.0%）。
磁场强度/序列：3.0T T2 加权涡轮自旋回波-短时间反转恢复序列、真实快速成像稳态进动闪光序列和快速低角度 shot 3D 扰相梯度回波序列。
评估
比较 KD 组与对照组之间的 T2 值。
统计学检验
学生 t 检验和 Fisher 精确检验；单因素方差分析；Pearson 相关分析；接收者操作曲线分析；多变量线性回归。
结果
急性期 KD 患者的整体 T2 值最高，其次是慢性期患者和对照组（38.83±2.41msec 比 37.55±2.28msec 比 36.05±1.64msec）。区域性 T2 值也呈现出相同的趋势。急性期和慢性期 KD 患者无论是否存在冠状动脉（CA）扩张，其整体和区域性 T2 值均无显著差异（所有 KD 患者：P=0.51，0.51，0.53，0.72；急性期 KD：P=0.61，0.37，0.33，0.83；慢性期 KD：P=0.65，0.79，0.62，0.79）。Z 评分>5.0 和 2.0<Z 评分≤5.0 的 KD 患者之间，整体 T2 值无显著差异（P=0.65）。多变量分析表明，疾病分期（β=-0.123）和心率（β=0.280）与整体 T2 值独立相关。
数据结论
急性期 KD 患者的心肌水肿程度比慢性期更严重。心肌水肿在存在或不存在 CA 扩张的患者中持续存在。
证据水平
2 级技术功效：2 级。
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