T1 Mapping in Cardiomyopathy at Cardiac MR: Comparison with Endomyocardial Biopsy
T1 Mapping in Cardiomyopathy at Cardiac MR: Comparison with Endomyocardial Biopsy
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DOI：
10.1148/radiol.12112721
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发表时间：
2012-12-01
期刊：
影响因子：
19.7
通讯作者：
Bluemke, David A.
中科院分区：
文献类型：
--
作者：
Sibley, Christopher T.;Noureldin, Radwa A.;Bluemke, David A.
目的：比较心脏磁共振（MR） T1标测在弥漫性心肌纤维化定量诊断中的应用价值。材料和方法：本研究符合hipaa标准，经机构审查委员会批准。回顾性分析了5年间在一家机构接受心肌病活检和心脏MR的心肌病患者。47例患者（53%男性，平均年龄46.8岁）接受了诊断性心脏MR和心内膜活检。13名健康志愿者（54%为男性，平均年龄38.1岁）接受了心脏MR作为参考。在1.5 t磁共振成像仪上使用倒置恢复Look-Locker序列，在注射0.2 mmol/kg螯合钆后10.7分钟+/- 2.7（标准差）进行心肌T1定位。采用梯度-回波反演-恢复序列评估晚期钆增强。心脏MR结果是两位对组织病理学结果不知情的放射科医生的一致意见。采用马松三色染色标本的数字图像，采用自动图像分析软件定量测量心内膜活检纤维化。两名不知道心脏MR结果的病理学家报告了组织病理学结果。统计分析包括Mann-Whitney U检验、方差分析和线性回归。结果：心肌纤维化中位数为8.5%（四分位数间距为5.7-14.4）。对照组T1次明显高于无钆增强组和晚期钆增强组（分别为466 msec +/- 14、406 msec +/- 59、303 msec +/- 53， P < 0.001）。T1时间与组织学纤维化呈负相关（r = -0.57； 95%可信区间：-0.74,-0.34;P < 0.0001）。心肌T1检测纤维化大于5%的时间曲线下面积为0.84，截止时间为383 msec。结论：心脏MR T1标测可为评价心肌病的患者提供弥漫性心肌纤维化的无创证据。(c) rsna, 2012
Purpose: To determine the utility of cardiac magnetic resonance (MR) T1 mapping for quantification of diffuse myocardial fibrosis compared with the standard of endomyocardial biopsy.Materials and Methods: This HIPAA-compliant study was approved by the institutional review board. Cardiomyopathy patients were retrospectively identified who had undergone endomyocardial biopsy and cardiac MR at one institution during a 5-year period. Forty-seven patients (53% male; mean age, 46.8 years) had undergone diagnostic cardiac MR and endomyocardial biopsy. Thirteen healthy volunteers (54% male; mean age, 38.1 years) underwent cardiac MR as a reference. Myocardial T1 mapping was performed 10.7 minutes +/- 2.7 (standard deviation) after bolus injection of 0.2 mmol/kg gadolinium chelate by using an inversion-recovery Look-Locker sequence on a 1.5-T MR imager. Late gadolinium enhancement was assessed by using gradient-echo inversion-recovery sequences. Cardiac MR results were the consensus of two radiologists who were blinded to histopathologic findings. Endomyocardial biopsy fibrosis was quantitatively measured by using automated image analysis software with digital images of specimens stained with Masson trichrome. Histopathologic findings were reported by two pathologists blinded to cardiac MR findings. Statistical analyses included Mann-Whitney U test, analysis of variance, and linear regression.Results: Median myocardial fibrosis was 8.5% (interquartile range, 5.7-14.4). T1 times were greater in control subjects than in patients without and in patients with evident late gadolinium enhancement (466 msec +/- 14, 406 msec +/- 59, and 303 msec +/- 53, respectively; P < .001). T1 time and histologic fibrosis were inversely correlated (r = -0.57; 95% confidence interval: -0.74, -0.34; P < .0001). The area under the curve for myocardial T1 time to detect fibrosis of greater than 5% was 0.84 at a cutoff of 383 msec.Conclusion: Cardiac MR with T1 mapping can provide noninvasive evidence of diffuse myocardial fibrosis in patients referred for evaluation of cardiomyopathy. (C) RSNA, 2012