Ciliberti Paolo, Bordonaro Veronica, Curione Davide, Perazzolo Alessio, Ciancarella Paolo, Santangelo Teresa, Napolitano Carmela, Natale Luigi, Galletti Lorenzo, Secinaro Aurelio
Cardiology Unit, Bambino Gesù Children's Hospital IRCSS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
Advanced Cardiothoracic Imaging Unit and Multimodality Imaging Research Unit, Bambino Gesù Children's Hospital IRCSS, Rome, Italy.
Eur Heart J Cardiovasc Imaging. 2024 Dec 31;26(1):161-168. doi: 10.1093/ehjci/jeae187.
Cardiac magnetic resonance (CMR) parametric mapping is underexplored in cardiac tumours. To evaluate the contribution of mapping sequences on the characterization of paediatric tumours.
All paediatric patients referred for cardiac tumours at Bambino Gesù Children's Hospital from June 2017 to November 2023, who underwent CMR with mapping sequences, were included. The diagnosis of tumour type was performed according to signal characteristics on different sequences. Mass parametric mapping for each subtype and interobserver variability was assessed. Sixteen patients were enrolled. The mean age at CMR was 7 ± 5 years. 'Traditional' mass type assessment diagnosed haemangioma (Group A) in three patients (19%), fibroma (Group B) in four patients (25%), rhabdomyoma (Group C) in six patients (37%), and lipoma (Group D) in three patients (19%). The analysis of variance analysis revealed significant differences in mass native T1 and mass extracellular volume (ECV) values among the four subgroups (P < 0.001 for both comparisons). The mean native T1 and ECV values were respectively 1465 ± 158 ms and 54 ± 4% for Group A, 860 ± 118 ms and 93 ± 4% for Group B, 1007 ± 57 ms and 23 ± 5% for Group C, and 215 ± 13 ms and 0 ± 0% for Group D.
Mass mapping analysis is feasible and reproducible in children. ECV values provide the most accurate differentiation. Mass ECV consistently resembles normal myocardium in rhabdomyoma, is extremely high (approaching 100%) in fibroma, equals to zero in lipoma, and matches blood pool ECV (1-Hct) in haemangioma.
心脏磁共振（CMR）参数成像在心脏肿瘤中的应用尚未得到充分研究。旨在评估成像序列对小儿肿瘤特征描述的贡献。
纳入2017年6月至2023年11月在 Bambino Gesù 儿童医院因心脏肿瘤接受CMR成像序列检查的所有小儿患者。根据不同序列上的信号特征进行肿瘤类型诊断。评估每种亚型的肿块参数成像及观察者间的变异性。共纳入16例患者。CMR检查时的平均年龄为7±5岁。“传统”的肿块类型评估诊断出3例（19%）血管瘤（A组）、4例（25%）纤维瘤（B组）、6例（37%）横纹肌瘤（C组）和3例（19%）脂肪瘤（D组）。方差分析显示，四个亚组之间的肿块固有T1值和肿块细胞外容积（ECV）值存在显著差异（两项比较P均<0.001）。A组的平均固有T1值和ECV值分别为1465±158 ms和54±4%，B组为860±118 ms和93±4%，C组为1007±57 ms和23±5%，D组为215±13 ms和0±0%。
肿块成像分析在儿童中是可行且可重复的。ECV值提供了最准确的鉴别。横纹肌瘤的肿块ECV始终类似于正常心肌，纤维瘤中极高（接近100%），脂肪瘤中等于零，血管瘤中与血池ECV（1 - 血细胞比容）匹配。
