| 陈铟铟,金航,任道元,杨姗,赵士海,恽虹,曾蒙苏.对比标准差法与绝对阈值法心脏MR T2* mapping技术定量评估心肌内出血[J].中国医学影像技术,2022,38(3):363~368 |
| 对比标准差法与绝对阈值法心脏MR T2* mapping技术定量评估心肌内出血 |
| Comparison on standard deviation and absolute threshold method for quantitative evaluation of intramyocardial hemorrhage with MR T2* mapping |
| 投稿时间：2021-07-23 修订日期：2021-12-18 |
| DOI：10.13929/j.issn.1003-3289.2022.03.011 |
| 中文关键词: 心肌梗死 再灌注损伤 出血 磁共振成像 |
| 英文关键词:myocardial infarction reperfusion injury hemorrhage magnetic resonance imaging |
| 基金项目:上海市卫生健康委员会科研课题（202040349）、上海市浦江人才计划（21PJD012）。 |
| 作者 | 单位 | E-mail | | 陈铟铟 | 复旦大学附属中山医院放射科, 上海 200032
复旦大学上海医学院影像学系, 上海 200032 | | | 金航 | 复旦大学附属中山医院放射科, 上海 200032
复旦大学上海医学院影像学系, 上海 200032 | | | 任道元 | 复旦大学附属中山医院心内科, 上海 200032 | | | 杨姗 | 复旦大学附属中山医院放射科, 上海 200032
复旦大学上海医学院影像学系, 上海 200032 | | | 赵士海 | 复旦大学附属中山医院放射科, 上海 200032
复旦大学上海医学院影像学系, 上海 200032 | | | 恽虹 | 复旦大学附属中山医院放射科, 上海 200032
复旦大学上海医学院影像学系, 上海 200032 | | | 曾蒙苏 | 复旦大学附属中山医院放射科, 上海 200032
复旦大学上海医学院影像学系, 上海 200032 | zeng.mengsu@zs-hospital.sh.cn |
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| 中文摘要: |
| 目的 对比观察标准差法与绝对阈值法MR T2* mapping技术以1.5T和3.0T场强设备定量评估ST段抬高型心肌梗死（STEMI）再灌注后心肌内出血（IMH）的价值。方法 前瞻性纳入70例将接受经皮冠状动脉介入治疗（PCI）的STEMI患者，随机均分为1.5T组和3.0T组（1∶1比例）。于PCI术后5~7天（IMH急性期）及6~8个月（IMH慢性期）于1.5T和3.0T场强下行心脏扫描，包括电影、T2* mapping和延迟增强序列扫描；采用标准差法与绝对阈值法测量IMH T2*值和IMH容积在左心室容积中所占百分比（IMH容积百分比），比较2种方法的差异，确定采用绝对阈值法评估IMH时与标准差法等效的T2*阈值（等效T2*阈值）。结果 共40例STEMI患者发生再灌注后IMH，1.5T组与3.0T组各20例。以1.5T场强、标准差法测得的IMH T2*值及容积百分比均大于绝对阈值法（P均<0.05），3.0T场强、标准差法测量的IMH急性期容积百分比小于绝对阈值法（P<0.05）。1.5T场强下，绝对阈值法的等效T2*阈值为22 ms，其诊断慢性期IMH的曲线下面积（AUC）显著大于标准T2*值（Z=2.08，P=0.04）。3.0T场强下，等效T2*阈值为18 ms （IMH急性期）或20 ms （IMH慢性期）；以18 ms诊断急性期IMH的AUC与标准T2*值无明显差异（Z=1.47，P=0.14）。1.5T及3.0T场强下，等效T2*阈值绝对阈值法与标准差法量化的IMH容积百分比均无明显差异（P均>0.05）。结论 1.5T、3.0T场强，尤其1.5T场强下，以标准差法与绝对阈值法T2* mapping技术定量评估STEMI再灌注后IMH存在一定差异；适当调整绝对阈值法T2*阈值可缩小其差异。 |
| 英文摘要: |
| Objective To compare standard deviation and absolute threshold method for quantitative evaluation on intramyocardial hemorrhage (IMH) of ST-segment elevation myocardial infarction (STEMI) after reperfusion with MR T2* mapping under 1.5T and 3.0T magnetic field intensities. Methods Totally 70 STEMI patients who would underwent percutaneous coronary intervention (PCI) were prospectively enrolled and randomly divided into 1.5T group and 3.0T group according to 1:1 ratio. Cardiac MR scanning were performed 5-7 days (IMH acute phase) and 6-8 months (IMH chronic phase) after PCI under 1.5T and 3.0T magnetic field intensities with sequences of cine, T2* mapping and late gadolinium enhancement. IMH T2* value and the percentage of IMH volume in left ventricular volume (IMH volume percentage) were measured with standard deviation and absolute threshold method, and the differences between 2 methods were observed. The T2* thresholds of absolute threshold method for evaluating IMH equivalent to standard deviation method (equivalent T2* threshold) were determined. Results IMH after reperfusion occurred in all 40 STEMI patients. There were 20 cases in 1.5T group and 20 cases in 3.0T group. Under 1.5T, IMH T2* value and volume percentage measured with standard deviation method were both greater than those measured with absolute threshold method (all P<0.05). Under 3.0T, IMH volume percentage in acute phase measured with standard deviation method was less than that measured with absolute threshold method (P<0.05). Under 1.5T, the equivalent T2* threshold of absolute threshold method was 22 ms, and the area under the curve (AUC) for diagnosis of chronic IMH was significantly greater than that of standard T2* value (Z=2.08, P=0.04), while under 3.0T, the equivalent T2* threshold was 18 ms (IMH acute phase) or 20 ms (IMH chronic phase), and there was no significant difference of AUC for diagnosing acute IMH between standard T2* value and 18 ms equivalent T2* threshold (Z=1.47, P=0.14). No significant difference of IMH volume percentage quantified with absolute threshold method with equivalent T2* threshold nor standard deviation method was found between 1.5T and 3.0T (all P>0.05).Conclusion There were differences between standard deviation and absolute threshold method for quantitatively evaluating IMH of STEMI after reperfusion with T2* mapping under 1.5T and 3.0T magnetic field intensities, especially under 1.5T, which could be reduced by appropriately adjusting T2* threshold of absolute threshold method. |
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