【摘要】 目的探讨心脏磁共振特征追踪技术在射血分数(EF)保留急性心肌炎心功能受损中的评估价值。方法回顾性收集49例心肌炎病例,并招募了50例正常志愿者作为对照,利用心脏磁共振特征追踪技术,分析心肌炎、EF值保留心肌炎与对照组的心脏磁共振参数与心肌应变的变化特征。结果结果显示心肌炎组较对照组的EF(55.39%±17.55%比66.28%±5.36%)、心肌径向应变(PSR)(25.97%±11.77%比40.80%±9.68%)、圆周应变(PSC)(-16.47%±6.27%比-22.19%±2.76%)、纵向应变(PSL)(-10.49%±4.40%比-14.50%±2.56%)是下降的。EF保留心肌炎组较对照组的PSR(31.30%±7.16%比40.80%±9.68%)、PSC(-19.64%±2.44%比-22.19%±2.76%)、PSL(-12.14%±3.75%比-14.50%±2.56%)也是下降的。ROC曲线分析结果显示PSR,PSC鉴别心肌炎与正常病例的AUC最大(为0.84),其中PSR的临界值取33.61%时,敏感度为76%,特异度为80%,而PSC的临界值为-20.14%时,敏感度为73%,特异度为84%。而在区分EF保留心肌炎与正常者的能力方面,PSR的AUC值最大(为0.79),当PSR的临界值为35.82%时,敏感度为70%,特异度为75%。结论利用心脏磁共振特征特征追踪技术能发现EF保留心肌炎患者的心肌应变受损,有助于对早期心功能受损的识别与评估。更多还原

【Abstract】 Objective To assess the value of cardiac magnetic resonance(MR) feature tracking in acute myocarditis. Methods Forty-nine patients with acute myocarditis and 50 healthy volunteers underwent were cardiac MR feature tracking imaging. Myocardial strain and conventional parameters were compared. Results In acute myocarditis, the left ventricular ejection fraction(LVEF: 55.39%±17.55%) and peak strain radial(PSR: 25.97% ±11.77%) were significantly lower than that of healthy control(66.28% ±5.36%,40.80%±9.68%) whereas the peak strain circumferential(PSC:-16.47%±6.27%) and peak strain longitudinal(PSL:-10.49%±4.40%)were higher than that of control(-22.19%±2.76%,-14.50%±2.56%). In patients with acute myocarditis with preserved LVEF, the PSR(31.30%±7.16%) was also lower than that of control(40.80%±9.68%) whereas the PSC(-19.64%±2.44%) and PSL(-12.14%±3.75%) were higher than that of control(-22.19%± 2.76%,-14.50%±2.56%). Receiver operating characteristic curve analysis showed that the areas under the curves(AUC) of PSR and PSC were the best(0.84) for differentiating acute myocarditis from healthy control.At the cutoff PSR value of 33.61%, the sensitivity was 76% and the specificity was 80%. Using the cutoff PSC value of-20.14%, the sensitivity was 73% and the specificity was 84%. PSR showed the best performance(AUC=0.79) of differentiation between LVEFpreserved myocarditis and healthy control with 70% sensitivity and 75% specificity at cutoff value of 35.82%. Conclusion Cardiac MR feature tracking imaging can detect decreased myocardial strain in LVEF-preserved myocarditis and assess early left ventricular dysfunction in acute myocarditis.更多还原