Shen Honghu, Wang Lin, Lian Jianxiu, Shi Ying, Liu Pengfei
Department of Magnetic Resonance, The First Affiliated Hospital of Harbin Medical University, Harbin, 150000, China.
Department of Radiology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150000, China.
Int J Cardiovasc Imaging. 2025 Jul;41(7):1277-1286. doi: 10.1007/s10554-025-03410-0. Epub 2025 Apr 29.
This study aimed to use T1 mapping and left atrial feature tracking techniques to distinguish myocardial amyloidosis (CA) from hypertrophic cardiomyopathy (HCM).
A retrospective analysis was conducted on 130 subjects who underwent cardiac magnetic resonance examinations from January 2021 to May 2024 at 1.5 and 3.0 T systems. Measurements of global left ventricular myocardial T1 values were performed, a standardized T1 z-score used as an assessment metric to overcome the effects of various manufacturers and field strengths. Left atrial strain was measured with feature tracking techniques.
42 CA patients、58 HCM patients and 30 healthy subjects were analyzed. For both 1.5T and 3.0T systems, the overall T1 values of LV myocardium was significantly higher in the CA group compared with the HCM and control groups (p < 0.001). T1z-scores in the CA and HCM groups were 4.8 ± 2.2 and 3.4 ± 1.9, respectively (p < 0.001). Myocardial strain analysis showed that atrial strain was significantly lower in the CA group when compared with the HCM and healthy control groups (p < 0.05). The correlation between left atrial strain and function parameters was assessed through Spearman correlation analysis. Multivariate logistic regression analysis showed that a combination model including T1z-score and left atrial reservoir function (Es) had an improved ability to discriminate CA and HCM with a higher AUC (0.937), with a sensitivity of 95.2% and a specificity of 83.3% (P < 0.05).
T1 mapping combined with Εs could effectively distinguish CA from HCM, and provide new insights for the diagnosis of the etiology and treatment of cardiac hypertrophic diseases.
本研究旨在运用T1映射和左心房特征追踪技术，区分心肌淀粉样变性（CA）与肥厚型心肌病（HCM）。
对2021年1月至2024年5月在1.5T和3.0T系统上接受心脏磁共振检查的130名受试者进行回顾性分析。测量左心室整体心肌T1值，采用标准化T1 z评分作为评估指标，以克服不同厂家和场强的影响。用特征追踪技术测量左心房应变。
分析了42例CA患者、58例HCM患者和30名健康受试者。对于1.5T和3.0T系统，CA组左心室心肌的整体T1值显著高于HCM组和对照组（p < 0.001）。CA组和HCM组的T1 z评分分别为4.8±2.2和3.4±1.9（p < 0.001）。心肌应变分析显示，与HCM组和健康对照组相比，CA组的心房应变显著降低（p < 0.05）。通过Spearman相关性分析评估左心房应变与功能参数之间的相关性。多因素逻辑回归分析显示，包含T1 z评分和左心房储备功能（Es）的组合模型对CA和HCM的鉴别能力有所提高，AUC更高（0.937），敏感性为95.2%，特异性为83.3%（P < 0.05）。
T1映射结合Es能够有效区分CA与HCM，并为心脏肥厚性疾病的病因诊断和治疗提供新的见解。
