| 黄璐,夏黎明,韩瑞,孙子燕,白杨.磁共振心肌首过灌注成像评价肥厚型心肌病微循环功能障碍[J].中国医学影像技术,2013,29(3):394~397 |
| 磁共振心肌首过灌注成像评价肥厚型心肌病微循环功能障碍 |
| Magnetic resonance first-pass myocardial perfusion for evaluation on coronary microvascular dysfunction in hypertrophic cardiomyopathy |
| 投稿时间：2012-08-09 修订日期：2012-11-07 |
| DOI： |
| 中文关键词: 心肌病,肥厚性 磁共振成像 微血管功能障碍 首过灌注 |
| 英文关键词:Cardiomyopathy, hypertrophic Magnetic resonance imaging Microvascular dysfunction First-pass myocardial perfusion |
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| 中文摘要: |
| 目的: 应用MR心肌首过灌注成像评价肥厚型心肌病患者局部心肌微循环障碍。方法: 选取22例肥厚型心肌病患者(HCM组)和13名健康志愿者(对照组)行心脏MR (CMR)检查(包括左心室短轴电影、心肌首过灌注和延迟增强序列),测量左心室舒张末期各心肌节段心肌壁厚度、心肌信号强度最大上升斜率(Slopemax)和心肌延迟强化(DE)。采用单因素方差分析比较对照组心肌节段、HCM组非肥厚性心肌节段亚组和肥厚性心肌节段亚组的Slopemax以及不同肥厚程度心肌节段的Slopemax,对有DE心肌节段和无DE心肌节段的Slopemax的差异采用独立样本t检验进行分析。结果: HCM组中非肥厚性心肌节段亚组和肥厚性心肌节段亚组Slopemax均明显低于对照组(P均<0.05),其中肥厚性心肌节段亚组的Slopemax较非肥厚性心肌节段亚组降低更为显著(P<0.05);轻度肥厚心肌节段Slopemax高于中度、重度肥厚心肌节段(P均<0.05),但中度与重度心肌肥厚节段Slopemax的差异无统计学意义(P>0.05)。DE心肌节段Slopemax明显低于无DE心肌节段(P<0.05)。结论: MR心肌首过灌注成像能可靠地检出HCM局部心肌的微血管功能障碍,为临床对HCM患者进行风险分层、制定治疗计划和预后评估提供有价值的信息。 |
| 英文摘要: |
| Objective: To evaluate the coronary microvascular dysfunction in patients with hypertrophic cardiomyopathy (HCM) by MR first-pass perfusion. Methods: Totally 22 patients with HCM (HCM group) and 13 healthy volunteers (control group) underwent cardiac magnetic resonance (CMR), including short axial cine, first-pass myocardial perfusion and myocardial delay enhanced scanning. The left ventricular end-diastolic wall thickness, maximal upslope of myocardial intensity enhancement (Slopemax) and myocardial delay enhancement (DE) were assessed. The difference of Slopemax between control group and HCM group, non-hypertrophic segments subgroup and hypertrophic segments subgroup, and among different levels of hypertrophic segments were compared by one-way ANOVA, and Slopemax of DE and non-DE segments also was compared by independent-sample t-test. Results: Compared to control group, Slopemax decreased in non-hypertrophic segments subgroup and hypertrophic segments subgroup (P<0.05), while reduced more significantly in hypertrophic segments subgroup. Slopemax of mild hypertrophic segments were higher than that of medium and severe hypertrophic segments (both P<0.05), but the difference of Slopemax between medium and severe hypertrophic segments was not significant (P>0.05).Slopemax of DE segments were significantly lower than that of non-DE segments (P<0.05). Conclusion: CMR resting first-pass myocardial perfusion is able to detect microvascular dysfunction in patients with HCM, therefore providing more information for risk stratification, therapy planning and prognosis evaluation of HCM patients. |
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