【摘要】 目的 基于心脏MRI应变分析技术比较放射性心肌炎（RM）与非放射性心肌炎（NRM）患者的心脏功能、结构特征及临床意义。方法 回顾性收集2019年9月至2024年12月福建医科大学附属龙岩第一医院18例RM患者、29例NRM患者及17例健康对照者的心脏磁共振成像及临床实验室数据。采用Wilcoxon秩和检验、独立样本t检验及logistic回归分析系统评估患者的临床特征、生物标志物水平及心脏MRI结构及功能参数。结果 RM组心肌肌钙蛋白I（cTnI）值、每搏输出量（SV）值低于NRM组（P=0.003、0.027）。RM的纵向应变低于NRM组（P=0.033）。在射血分数（EF）保留型心肌炎中RM组与NRM组在周向应变间差异有统计学意义（P=0.036）;RM组纵向应变、径向位移均与对照组及NRM组差异有统计学意义（P<0.05）。logistic回归分析表明左心室质量及径向位移峰值是EF保留型RM的独立危险因素。结论 心脏MRI功能及应变参数有助于区分EF保留型RM与NRM及正常人群，其中左心室心肌质量及径向位移峰值能预测RM的早期损伤。更多还原

【Abstract】 Objective To compare cardiac functional and structural characteristics between patients with radioactive myocarditis(RM) and non-radioactive myocarditis(NRM) using cardiac MRI strain analysis. Methods Cardiac magnetic resonance imaging(CMR) and clinical laboratory data were collected retrospectively from 18 RM, 29 NRM, and 17 healthy controls at Longyan First Hospital Affiliated to Fujian Medical University between September 2019 and December 2024. Wilcoxon rank-sum test, independent t-test and binary logistic regression were performed using to evaluate clinical features, biomarker levels, and CMR-derived parameters. Results The RM group exhibited significantly lower cardiac troponin I(cTnI) and stroke volume(SV) compared to the NRM group(P=0.003 and P=0.027, respectively). Longitudinal strain was reduced in RM patients(P=0.033). Among ejection fraction(EF)-preserved myocarditis patients, circumferential strain was significantly lower in the RM group than in the NRM group(P=0.036); Longitudinal strain and radial displacement in the RM group differed significantly from both the NRM group and controls(P<0.05). Univariate and multivariate logistic regression identified left ventricular mass and peak radial displacement as independent risk factors for RM(P<0.05). Conclusion CMR-derived functional and strain parameters effectively distinguish EF-reserved RM from NRM and healthy individuals. LV mass and peak radial displacement are critical predictors of early radiation-induced myocardial injury.更多还原