心脏磁共振成像中二尖瓣环分离的患病率：多中心注册研究结果
Prevalence of Mitral Annular Disjunction at Cardiac MRI: Results from a Multicenter Registry.
作者信息
Palmisano Anna, Bruno Elisa, Aquaro Giovanni Donato, De Gori Carmelo, Barbieri Simone, Adami Margherita, Plataroti Dario, Rondi Paolo, di Meo Nunzia, Ravanelli Marco, Farina Davide, Rossi Alice, Pradella Silvia, Miele Vittorio, Marchitelli Livia, Cundari Giulia, Galea Nicola, Tore Davide, Gatti Marco, Faletti Riccardo, Palumbo Pierpaolo, Di Cesare Ernesto, D'Angelo Tommaso, Lanzafame Ludovica R M, Blandino Alfredo, Dell'Aversana Serena, Ponsiglione Andrea, Ascione Raffaele, Imbriaco Massimo, Porcu Michele, Cau Riccardo, Saba Luca, Ferrandino Giovanni, Liguori Carlo, Sambuceti Virginia, Seitun Sara, Siani Agnese, Carriero Alessandro, Cosenza Michele, Lovato Luigi, Vignale Davide, Faggioni Lorenzo, Neri Emanuele, Esposito Antonio
机构信息
From the Department of Radiology, School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58-60, 20132 Milan, Italy (A. Palmisano, E.B., S.B., D.V., A.E.); Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy (A. Palmisano, E.B., M.C., D.V., A.E.); Academic Radiology Department of Translational Research, University of Pisa, Pisa, Italy (G.D.A., C.D.G., M.A., D.P., L.F., E.N.); Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Department of Radiodiagnostics, Università di Brescia-Spedali Civili, Brescia, Italy (P.R., N.d.M., M.R., D.F.); Department of Emergency Radiology, University Hospital Careggi, Florence, Italy (A.R., S.P., V.M.); Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy (L.M., G.C., N.G.); Department of Surgical Sciences, University of Turin, Turin, Italy (D.T., M.G., R.F.); Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, L'Aquila, Italy (P.P.); Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy (E.D.C.); Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Policlinico, Messina, Italy (T.D., L.R.M.L., A.B.); Department of Radiology, Santa Maria delle Grazie Hospital, Pozzuoli, Italy (S.D.); Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy (A. Ponsiglione, R.A., M.I.); Department of Radiology, AOU Cagliari, University of Cagliari, Cagliari, Italy (M.P., R.C., L.S.); Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Naples, Italy (G.F., C.L.); Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy (V.S., S.S.); Department of Radiology, Ospedale Maggiore della Carità University Hospital, Novara, Italy (A.S., A.C.); and IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Italy (L.L.).
出版信息
Radiol Cardiothorac Imaging. 2024 Dec;6(6):e230428. doi: 10.1148/ryct.230428.
Purpose To determine the prevalence of mitral annular disjunction (MAD) in patients undergoing cardiac MRI for various clinical indications and to assess the association of MAD with arrhythmia, mitral valve prolapse (MVP), and myocardial alteration. Materials and Methods This study analyzed data from a retrospective observational registry of consecutive patients undergoing cardiac MRI for different clinical indications. Cardiac MRI examinations were performed from January 2019 to June 2019 at 13 Italian hospitals. Images underwent double reading by expert cardiac radiologists from the enrolling center and the core laboratory to assess the presence of MAD. Presence and maximum length of MAD and its association to MVP pattern, functional and structural myocardial alteration, and arrhythmia were evaluated using nonparametric and parametric tests. Logistic regression models were used to identify predictors of arrhythmia. Results Cardiac MRI studies from 2611 consecutive patients (1730, 66% male; median age, 53 years; IQR, 39-65 years) were evaluated. Prevalence of MAD was 5.44% (142 of 2611). MAD was an incidental finding in 74.6% (106 of 142) of patients. Patients with MAD had a higher prevalence of arrhythmias compared with patients without MAD (40% [57 of 142] vs 18% [444 of 2469]; < .001). Patients with MAD and bileaflet MVP showed a longer MAD compared with patients with single-leaflet or absent MVP (median, 7 mm [IQR, 3-9.5 mm] vs 4 mm [IQR, 3-5 mm]; < .001), a higher prevalence of systolic curling (75% [21 of 28] vs 30.7% [35 of 114]; < .001), higher extracellular volume values (30% [IQR, 28%-32%] vs 27% [IQR, 25%-30%]; = .04), and a higher prevalence of arrhythmia (64.2% [18 of 28] vs 34.2% [39 of 114]; = .006). MAD length of at least 5 mm was an independent predictor of arrhythmia (odds ratio 3.96; 95% CI: 1.93, 8.15; < .001). Conclusion MAD was a frequent incidental finding on cardiac MRI scans from a multicenter registry. MAD length of at least 5 mm and coexisting bileaflet MVP showed a higher risk of arrhythmia. MR Imaging, Cardiac, Mitral Annular Disjunction ©RSNA, 2024.
目的 确定因各种临床指征接受心脏磁共振成像（MRI）检查的患者中二尖瓣环分离（MAD）的患病率，并评估MAD与心律失常、二尖瓣脱垂（MVP）和心肌改变之间的关联。材料与方法 本研究分析了来自一个回顾性观察登记库的数据，该登记库纳入了因不同临床指征接受心脏MRI检查的连续患者。2019年1月至2019年6月在意大利13家医院进行了心脏MRI检查。图像由参与中心和核心实验室的心脏放射学专家进行双重解读，以评估MAD的存在情况。使用非参数和参数检验评估MAD的存在情况、最大长度及其与MVP模式、功能性和结构性心肌改变以及心律失常的关联。采用逻辑回归模型确定心律失常的预测因素。结果 对2611例连续患者（1730例，66%为男性；中位年龄53岁；四分位间距，39 - 65岁）的心脏MRI研究进行了评估。MAD的患病率为5.44%（2611例中的142例）。74.6%（142例中的106例）的患者MAD为偶然发现。与无MAD的患者相比，有MAD的患者心律失常的患病率更高（40%[142例中的57例]对18%[2469例中的4 + 4例]；P <.001）。与单叶或无MVP的患者相比，有MAD和双叶MVP的患者MAD更长（中位值，7 mm[四分位间距，3 - 9.5 mm]对4 mm[四分位间距，3 - 5 mm]；P <.001），收缩期卷曲的患病率更高（75%[28例中的21例]对30.7%[114例中的35例]；P <.001），细胞外容积值更高（30%[四分位间距，28% - 32%]对27%[四分位间距，25% - 30%]；P =.04），心律失常的患病率更高（64.2%[28例中的18例]对34.2%[114例中的39例]；P =.006）。MAD长度至少5 mm是心律失常的独立预测因素（比值比3.96；95%置信区间：1.93，8.15；P <.001）。结论 在一个多中心登记库的心脏MRI扫描中，MAD是常见的偶然发现。MAD长度至少5 mm且并存双叶MVP显示心律失常风险更高。磁共振成像、心脏、二尖瓣环分离 ©RSNA，2024
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