【摘要】 目的 应用心脏磁共振特征追踪技术（CMR-FT）定量评估乳腺癌术后化疗患者左室心肌应变。方法 对17例乳腺癌术后靶向化疗前、后行心脏磁共振（CMR）检查评估；进行左室功能及容积分析，计算左室射血分数及容积参数；应用CMR-FT行左心肌应变分析，测量左室整体径向、圆周、纵向峰值应变及应变率，比较化疗前、后各个参数；ROC曲线分析，判断各参数的鉴别能力。结果 乳腺癌患者化疗后较化疗前左室射血分数、结构差异无统计学意义（P>0.05）。乳腺癌患者化疗后左室整体径向、圆周、纵向的峰值应变及应变率比化疗前下降，差异有统计学意义（P<0.05）;ROC曲线分析结果显示，PSSRL及PSC的AUC最大，分别为0.90、0.86，鉴别能力最高；当PSSRL取临界值-0.92%时，敏感度为77%，特异度为94%，当PSC取临界值-22.44%时，敏感度为77%，特异度为82%。结论 左室心肌应变分析能发现乳腺癌患者靶向治疗后的早期心脏功能损害，为临床提供乳腺癌患者靶向治疗左室功能受损依据。更多还原

【Abstract】 Objective To quantitatively evaluate left ventricular strain by cardiac magnetic resonance-feature tracking(CMR-FT)in breast cancer patients treated with postoperative chemotherapy. Methods Cardiac magnetic resonance(CMR)was performed before and after chemotherapy in 17 breast cancer patients who treated with postoperative targeted therapy. And left ventricular function and volume analysis and left ventricular myocardial strain analysis were performed respectively. The left ventricular ejection fraction and volume parameters and strain indices including radial, circumferential, and longitudinal peak strain and strain rate of left ventricular myocardium were calculated. All calculated parameters before and after chemotherapy were compared. ROC curve analysis was used to evaluated the discrimination ability of various parameters. Results There were no statistically significant differences in parameters of left ventricular ejection fraction and volume between the two groups(P>0.05). The peak strain and strain rate parameters of the left ventricular myocardium for the patients after chemotherapy were decreased compared with the indices of patients before chemotherapy, and the differences were statistically significant(P<0.05). ROC curve analysis results showed that PSSRL and PSC had the best AUC(0.90,0.86 respectively)and discrimination ability. When the cutoff value of PSSRL was set-0.92%, the sensitivity was 77% and the specificity was 94%. When the cutoff value of PSC was set-22.44%, the sensitivity was 77%, the specificity was 82%. Conclusion Left ventricular myocardial strain analysis can find early cardiac function damage in breast cancer patients treated with targeted therapy, and provide clinical evidence for left ventricular function impairment in these patients.更多还原