摘要
目的:应用磁共振心肌组织追踪技术定量评估高血压性心脏病(HHD)患者左室心肌形变率的变化。方法:对51例HHD患者[其中射血分数(EF)<50%组患者25名,EF>50%组患者26名]及37名健康志愿者进行心脏磁共振(CMR)检查,通过CVI42软件采用心肌组织追踪技术对左心室进行定量分析,获得全局轴向峰值形变(GPSR),全局周向峰值形变(GPSC),全局纵向峰值形变(GPSL)及各项左心功能参数,包括EF、舒张末期容积(EDV)、收缩末期容积(ESV)、每搏出量(SV)、排出量(CO)、左心指数(CI)、左室收缩期质量(Myo Mass Syst)及舒张期质量(Myo Mass Diast)。采用SPSS 21.0分析各心功能参数与左室全局心肌应变的相关性。结果:全局形变中GPSR、GPSL在三组间均差异具有统计学意义(P<0.05),对照组分别为48.5±26.6和-12.8±5.1,高血压心肌病早期(EF>50%)分别为32.1±11.9和-9.9±3.4,高血压心肌病临床期(EF<50%)分别为14.2±8.5和-3.9±5.5,且随EF进一步下降而降低;而GPSC仅在高血压心肌病临床期(-19.3±3.2)与对照组(-19.5±6.8)、高血压心肌病早期(-18.8±4.4)间差异无统计学意义(P<0.05),对照组和高血压心肌病早期的GPSC组间对比差异无统计学意义(P>0.05)。全局形变(GPSR、GPSC、GPSL)与EDV、ESV、EF、Myo Mass Diast、Myo Mass Syst分别呈明显相关(P<0.01,r值分别为-0.405、-0.566、0.629、-0.629、-0.555),与SV、CI、HR分别呈轻度相关(P<0.05,r值分别为0.255、0.244、-0.261)。结论:心肌特征追踪成像不仅可以分析室壁力学改变,还可显示出心肌疾病的严重程度,其定量参数对评估正常心肌和HHD患者的心肌功能具有重要价值。
Objective:To quantitatively evaluate the left ventricular myocardial strain by hypertensive cardiomyopathy using magnetic resonance myocardial tissue tracking method.Methods:Cardiac magnetic resonance(CMR)was performed in 51 patients with hypertensive heart disease(including 25 patients with ejection fraction(EF)<50%and 26 patients with EF>50%)and 37 healthy volunteers.The left ventricular global peak strain radial(GPSR),global peak strain long(GPSL),global peak strain circumferential(GPSC)and cardiac function were measured in MR imaging using CVI42 post-processing software,and then investigated the changes of global left ventricular peak strain and cardiac function between the patients with hypertensive heart disease and the healthy adult volunteers.Results:In global strain,GPSR and GPSL had significant difference among the three groups.The values in the control group were 48.5±26.6 and-12.8±5.1,respectively.In the early stage of hypertensive cardiomyopathy(EF<50%),they were 32.1±11.9 and-9.9±3.4,respectively.In the clinical stage of hypertensive cardiomyopathy(EF>50%),they were 14.2±8.5 and-3.9±5.5,respectively.And GPSR and GPSL were decreased with the decrease of EF.However,significant difference of GPSC only existed in the clinical stage of hypertensive cardiomyopathy.There was no significant difference between the control group(-19.5±6.8)and the early stage of hypertensive cardiomyopathy(-18.8±4.4).Global strain(GPSR,GPSC,GPSL)were significantly correlated with EDV,ESV,EF,Myo Mass Diast and Myo Mass Syst(P<0.01,R values were-0.405,-0.566,0.629,-0.629,-0.555,respectively),and slightly correlated with SV,CI and HR(P<0.05,R values were 0.255,0.244,-0.261,respectively).Conclusion:Myocardial characteristic tracking imaging can not only analyze the mechanical changes of ventricular wall,but also show the severity of myocardial disease.It can provide quantitative parameters for evaluating myocardial dysfunction in patients with normal myocardium and HHD.
作者
时园园
张勇
程敬亮
张文博
金红瑞
文萌萌
SHI Yuan-yuan;ZHANG Yong;CHENG Jing-liang(Department of Magnetic Resonance,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《放射学实践》
北大核心
2020年第7期873-877,共5页
Radiologic Practice
基金
国家重点研发计划(2016YFC0106900)。
关键词
高血压性心脏病
磁共振成像
特征追踪
心肌形变
Hypertensive heart disease
Magnetic resonance imaging
Feature tracking
Myocardial strain
作者简介
时园园(1989-),女,河南焦作人,硕士研究生,住院医师,主要从事磁共振影像诊断工作;通讯作者:张勇,E-mail:zzuzhangyong2013@163.com。
