| 张丽君,贺毅,范占明,赵轶轲,安靖,窦瑞雨.心肌T1 mapping和细胞外容积诊断陈旧心肌梗死[J].中国医学影像技术,2016,32(6):871~875 |
| 心肌T1 mapping和细胞外容积诊断陈旧心肌梗死 |
| MR T1 mapping and extracellular volume for detection of chronic myocardial infarction |
| 投稿时间：2016-01-04 修订日期：2016-04-13 |
| DOI：10.13929/j.1003-3289.2016.06.014 |
| 中文关键词: 心脏磁共振 心肌梗死 钆剂延迟强化 |
| 英文关键词:Cardiac magnetic resonance Myocardial infarction Lated gadolinium enhancement |
| 基金项目:首都医科大学基础-临床科研合作基金(15JL58)。 |
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| 中文摘要: |
| 目的 探讨心脏磁共振(CMR)T1 mapping技术对陈旧心肌梗死心肌纤维化的诊断价值。方法 对31例陈旧心肌梗死患者行心脏T1 mapping MOLLI序列和延迟强化检查,以延迟强化为金标准,将心肌节段分为阳性及阴性组,测定心肌17个节段初始T1值和强化后T1值,计算强化后T1缩短值(△T1)和细胞外容积(ECV),比较两组间初始T1值、△T1值和心肌ECV值的差异并行ROC曲线分析。结果 陈旧心肌梗死患者中LGE阳性和阴性节段的平均初始T1值、强化后T1值、△T1值和ECV值差异均有统计学意义[(1521.77±150.49)ms vs(1258.02±72.52)ms, P<0.001,(404.64±66.39)ms vs(594.92±66.92)ms,P<0.001,(1117.12±179.55)ms vs (663.10±103.12)ms,P<0.001, (57.76±11.07)% vs (27.72±5.61)%, P<0.001)]。采用初始T1值、△T1值和ECV诊断心肌梗死的ROC曲线下面积分别为0.964、0.994和0.990,初始T1阈值为1341.15 ms时,敏感度为91.75%(189/206),特异度为91.97%(275/299);△T1值阈值为843.05 ms时,敏感度为97.09%(200/206),特异度为96.66%(289/299);ECV阈值为38.87%时,敏感度为98.06%(202/206),特异度为96.99%(290/299)。采用初始T1值和ECV值诊断心肌梗死的准确率、敏感度、特异度、阳性预测值、阴性预测值的差异均有统计学意义([QX(Y10]P[QX)]均<0.05),而△T1值与ECV值比较,差异均无统计学意义([QX(Y10]P[QX)]均>0.05)。结论 心脏T1 mapping技术可用于识别及定量评估陈旧心肌梗死纤维化,其中心肌初始T1值、△T1值和ECV值的准确性均较高,且ECV明显高于初始T1值。 |
| 英文摘要: |
| Objective To investigate the diagnostic values of T1 mapping imaging and extracellular volume (ECV) for evaluating myocardial fibrosis in patients with chronic myocardial infarction (CMI). Methods A total of 31 patients with CMI were examined with T1 mapping MOLLI sequence and late gadolinium enhancement (LGE). CMI was defined as LGE positive and negative. T1 values of precontrast and postcontrast were measured, and the changing of T1 values (△T1) and ECVs were calculated. ROC curve analysis was performed for △T1 values and ECV for discrimination of CMI. Results The comparison of T1 values of LGE positive and negative revealed significant differences in precontrast, postcontrast scans, △T1 values and ECV ([1521.77±150.49]ms vs[1258.02±72.52]ms, P<0.001;[404.64±66.39]ms vs[594.92±66.92]ms, P<0.001;[1117.12±179.55]ms vs[663.10±103.12]ms, P<0.001;[57.76±11.07])% vs[27.72±5.61]%, P<0.001). ROC analysis with precontrast T1 values, △T1 values and ECV revealed areas under the curve of 0.964, 0.994 and 0.990. Sensitivities and specificities were 91.75% (189/206) and 91.97% (275/299) for detecting CMI by precontrast T1 values, 97.09% (200/206) and 96.66% (289/299) for △T1 values, and 98.06% (202/206) and 96.99% (290/299) for ECV, with cut-off values being 1341.15 ms, 843.05 ms or greater than 38.87%. Combined criteria accuracy, sensitivity and specificity, positive predictive value and negative predictive value revealed significant differences between precontrast T1 values and ECV (all P<0.05), but no significant differences in △T1 values and ECV (all P>0.05). Conclusion T1 mapping imaging can be a useful method to evaluate fibrosis in patients with CMI. Both parameters with precontrast T1 values, △T1 values and ECV allow for accurate detection of CMI, and ECV was significantly higher than precontrast T1 values. |
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