T1 mapping评价扩张型心肌病心肌纤维化

目的探讨T1 mapping评价扩张型心肌病(DCM)心肌纤维化的应用价值。方法对32例DCM患者(DCM组)和16名健康体检者(对照组)行T1mapping和延迟钆增强(LGE)扫描。根据DCM患者是否存在LGE分为LGE(+)亚组和LGE(-)亚组。根据LGE形态和区域,将LGE(+)亚组心肌分为线状LGE区、斑片状LGE区、弥漫性LGE区及远程区(正常心肌区)。分别测量对照组、DCM组、线状LGE区、斑片状LGE区、弥漫性LGE区、远程区T1值,并进行统计学分析。结果 DCM组T1值(1332.55±61.34)ms]明显高于对照组(1222.52±45.59)ms,P<0.001]。对照组心肌T1值与线状LGE区(1359.44±77.93)ms]、斑片状LGE区(1456.49±110.27)ms]、弥漫性LGE区(1524.17±52.30)ms]及远程区(1329.11±64.12)ms]比较,差异均有统计学意义(P均<0.001)。LGE(+)亚组T1值(1341.35±65.01)ms]与LGE(-)亚组(1310.06±45.57)ms]差异无统计学意义(P=0.199)。LGE和T1mapping成像诊断DCM组心肌纤维化的ROC曲线下面积分别为0.84、0.95。结论 T1mapping评价DCM心肌纤维化具有较高的应用价值。

T1 mapping evaluation of myocardial fibrosis in dilated cardiomyopathy

Objective To explore the value of T1 mapping in evaluation of myocardial fibrosis in dilated cardiomyopathy (DCM). Methods Totally 32 DCM patients (DCM group) and 16 healthy examined people (control group) were involved, who all underwent T1 mapping and late gadolinium-enhanced (LGE) scan. According to the presence of LGE in DCM group, the patients were divided into LGE (+) subgroup and LGE (-) subgroup. According to the LGE shape and region, the myocardial region in LGE (+) subgroup were classified into linear-LGE zone, patchy-LGE zone, diffuse-LGE zone and remote zone (normal myocardium area). T1 value was measured in control group, DCM group, linear-LGE zone, patchy-LGE zone, diffuse-LGE zone and remote zone in T1 mapping images. Statistical analysis was performed. Results T1 value in DCM group (1332.55±61.34]ms) was significantly higher than that in control group (1222.52±45.59]ms, P<0.001). Compared with control group, the difference of T1 value in linear-LGE zone (1359.44±77.93]ms), patchy-LGE zone (1456.49±110.27]ms), diffuse-LGE zone (1524.17±52.30]ms), remote zone (1329.11±64.12]ms) all had statistically significance (all P<0.001). The statistical difference of T1 value in LGE (+) subgroup (1341.35±65.01]ms) and LGE (-) subgroup (1310.06±45.57]ms) was not significant (P=0.199). The area under ROC curve of LGE and T1 mapping imaging in diagnosing myocardial fibrosis in DCM group were 0.84 and 0.95, respectively. Conclusion T1 mapping has a high application value in evaluating myocardial fibrosis in DCM.