Yang Yanbing, Yue Xiuzheng, Ruan Xiaowei, Wang Rui, Zhang Xiaowen, Tang Lusong, Yang Lili, Chen Dazhi, Wang Fang
Medical Imaging Center, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China.
Philips Healthcare, Beijing, China.
Quant Imaging Med Surg. 2025 Aug 1;15(8):7183-7194. doi: 10.21037/qims-24-1703. Epub 2025 Jul 30.
The grey area in myocardial infarction (MI) patients is crucial for prognosis. T1rho mapping is a promising magnetic resonance imaging (MRI) technique for ischemic cardiomyopathy. This study aims to investigate the feasibility of T1rho in evaluating the tissue characteristics of the grey area adjacent to the infarcted myocardium.
A total of 40 chronic MI patients with positive late gadolinium enhancement (LGE) and 23 healthy controls were enrolled in the study. For the MI patients, the myocardium was divided into the LGE core [5 standard deviation (SD) above remote myocardium], grey area (2-5 SD above remote myocardium), and remote myocardium based on LGE signal intensity. We compared the native T1, T1rho, and extracellular volume (ECV) values among different myocardial regions in MI patients and healthy controls and assessed their diagnostic performance in identifying grey areas.
The native T1, T1rho, and ECV values were significantly different across the four myocardium categories (LGE core, grey area, remote area, and healthy controls, P<0.001). Pairwise analysis showed significant differences in these parameters between the grey and remote areas (native T1: 1,341.34±57.27 . 1,264.79±46.42 ms; T1rho: 53.47±4.83 . 44.26±2.68 ms; ECV: 36.95%±5.66% . 28.03%±1.87%, all P<0.05). Receiver operating characteristic (ROC) analysis indicated that T1rho was a more effective discriminator between the LGE grey area and the remote area of patients [area under the curve (AUC): 0.985 . 0.863 and 0.982] compared to native T1 and ECV, with its Youden index reaching 0.921.
T1rho mapping presents a viable tool for detecting fibrosis of a grey area in chronic MI patients.
心肌梗死（MI）患者中的灰色区域对预后至关重要。T1rho成像技术是一种用于缺血性心肌病的很有前景的磁共振成像（MRI）技术。本研究旨在探讨T1rho成像技术在评估梗死心肌周围灰色区域组织特征方面的可行性。
本研究共纳入40例延迟钆增强（LGE）阳性的慢性MI患者和23名健康对照者。对于MI患者，根据LGE信号强度将心肌分为LGE核心区（比远隔心肌高5个标准差[SD]）、灰色区域（比远隔心肌高2 - 5个SD）和远隔心肌。我们比较了MI患者和健康对照者不同心肌区域的固有T1、T1rho和细胞外容积（ECV）值，并评估了它们在识别灰色区域方面的诊断性能。
在四类心肌（LGE核心区、灰色区域、远隔区域和健康对照者）中，固有T1、T1rho和ECV值存在显著差异（P<0.001）。两两分析显示，灰色区域和远隔区域之间这些参数存在显著差异（固有T1：1341.34±57.27. 1264.79±46.42毫秒；T1rho：53.47±4.83. 44.26±2.68毫秒；ECV：36.95%±5.66%. 28.03%±1.87%，均P<0.05）。受试者工作特征（ROC）分析表明，与固有T1和ECV相比，T1rho在区分患者的LGE灰色区域和远隔区域方面是更有效的鉴别指标[曲线下面积（AUC）：0.985. 0.863和0.982]，其约登指数达到0.921。
T1rho成像技术是检测慢性MI患者灰色区域纤维化的一种可行工具。
