Myocardial T1 mapping for detection of left ventricular myocardial fibrosis in chronic aortic regurgitation: pilot study.
Myocardial T1 mapping for detection of left ventricular myocardial fibrosis in chronic aortic regurgitation: pilot study.
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DOI：
10.2214/ajr.05.1264
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发表时间：
2006-12-01
期刊：
影响因子：
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通讯作者：
Sivananthan, Mohan U
中科院分区：
文献类型：
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作者：
Sparrow, Patrick;Messroghli, Daniel R;Sivananthan, Mohan U
目的：本研究的目的是通过比较飞行员患者组左心室心肌的T1弛豫时间与先前确定的正常时间范围来识别继发于慢性主动脉瓣反流的弥漫性心肌纤维化。8例慢性主动脉瓣反流和正常冠状动脉等待外科瓣膜置换术的患者接受了全面的MRI检查，包括评估左心室功能、瓣膜返流的严重程度和延迟增强证实的明显心肌瘢痕的存在。对于每个病人，心肌T1弛豫时间测定与一个改进的Look-Ehrman技术之前和之后的对比剂administration.Results之前建立的值进行了比较：有没有统计学差异（P > 0.05），在切片平均心肌T1弛豫时间无论是前或后钆管理的患者组与正常范围的时间相比。然而，在给予钆后10、15和20分钟，室壁运动异常的节段的节段平均T1弛豫时间与健康对照组相比确实显示出统计学显著差异（分别为510与476毫秒，p = 0.001; 532与501毫秒，p = 0.002; 560与516毫秒，p = 0.001）。两个主动脉瓣反流患者也有心肌延迟enhancement.CONCLUSION：基于节段的心肌T1映射有潜力显示主动脉瓣反流和正常心脏的松弛时间之间的差异，这表明存在弥漫性心肌纤维化过程。
OBJECTIVE: The aim of this study was to identify diffuse myocardial fibrosis secondary to chronic aortic regurgitation by comparing the T1 relaxation times of left ventricular myocardium in a pilot patient group with a previously established normal range of times.SUBJECTS AND METHODS: Eight patients with chronic aortic regurgitation and normal coronary arteries awaiting surgical valve replacement underwent a comprehensive MRI examination that included assessment of left ventricular function, severity of valvular regurgitation, and presence of overt myocardial scar evidenced by delayed enhancement. For each patient, myocardial T1 relaxation times determined with a modified Look-Locker technique before and after contrast administration were compared with values previously established for 15 healthy volunteers.RESULTS: There was no statistical difference (p > 0.05) in slice-averaged myocardial T1 relaxation times either before or after gadolinium administration in the patient group compared with the normal range of times. Segmental averaged T1 relaxation times in segments with abnormal wall motion did, however, show statistically significant differences from healthy controls 10, 15, and 20 minutes after administration of gadolinium (510 vs 476 milliseconds, p = 0.001; 532 vs 501 milliseconds, p = 0.002; 560 vs 516 milliseconds, p = 0.001, respectively). Two of the aortic regurgitation patients also had focal areas of myocardial delayed enhancement.CONCLUSION: Segment-based myocardial T1 mapping has the potential for showing differences between relaxation times in aortic regurgitation and in normal hearts, suggesting the existence of a diffuse myocardial fibrotic process.