Systolic Myocardial Dysfunction in Patients with Type 2 Diabetes Mellitus: Identification at MR Imaging with Cine Displacement Encoding with Stimulated Echoes
Systolic Myocardial Dysfunction in Patients with Type 2 Diabetes Mellitus: Identification at MR Imaging with Cine Displacement Encoding with Stimulated Echoes
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DOI：
10.1148/radiol.12112571
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发表时间：
2012-11-01
期刊：
影响因子：
19.7
通讯作者：
Croisille, Pierre
中科院分区：
文献类型：
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作者：
Ernande, Laura;Thibault, Helene;Croisille, Pierre
目的：确定编码刺激回声的电影置换(Density)是否有助于识别和确定2型糖尿病(DM)患者和对照组的亚临床心肌收缩功能障碍的模式。材料和方法：在获得机构伦理委员会的批准和患者的书面知情同意后，37例无明显心脏病的2型DM患者和23例年龄匹配的对照组患者被前瞻性纳入研究。患者接受了标准的电影磁共振(MR)成像，并进行了二维电影密度采集。在左心室底部、中部和心尖水平的短轴切面上测量周向(ECC)和径向(ERR)收缩应变。在四腔观和双腔观上测量纵向应变(Ell)。结果：观察者间ECC、ERR、E11组内相关系数分别为0.85、0.95、0.90，观察者间相关系数分别为0.79、0.91、0.80。与对照组相比，DM组的ECC(-14.4%+/-1.6 vs-17.0%+/-1.6，P<；.001)、ERR(36.2%+/-10.9 vs 44.4%+/-9.9，P=.006)和Ell(-12.9%+/-2.1 vs-15.5%+/-1.6，P<；.001)明显降低。在调整了年龄、性别、高血压、体重指数和左心室重量后，DM与ECC(P<；.001)、ERR(P=.05)和Ell(P=.01)独立相关。结论：Cine Density是一种高空间分辨率的运动编码MR心肌应变评估技术，可用于诊断DM患者的亚临床心肌功能障碍。
Purpose: To determine if cine displacement encoding with stimulated echoes (DENSE) can help to identify and determine the patterns of subclinical myocardial systolic dysfunction in patients with type 2 diabetes mellitus (DM) when compared with cine DENSE in control patients.Materials and Methods: After obtaining approval from the institutional ethics committee and written informed consent from the patients, 37 patients with type 2 DM without overt heart disease and 23 age-matched control patients were prospectively included in the study. The patients underwent standard cine magnetic resonance (MR) imaging with two-dimensional cine DENSE acquisitions. Circumferential (Ecc) and radial (Err) systolic strains were measured on short-axis views at basal, mid, and apical left ventricular levels. Longitudinal strain (Ell) was measured on four-and two-chamber views. Statistical testing included the intraclass correlation coefficient and multiple linear regression analysis.Results: The intraobserver intraclass correlation coefficient values were 0.85, 0.95, and 0.90, and the interobserver intraclass correlation coefficient values were 0.79, 0.91 and 0.80 for Ecc, Err, and Ell, respectively. The left ventricular ejection fraction was in the reference range and similar between the groups, and the patients with DM showed a decrease in Ecc (-14.4% +/- 1.6 vs -17.0% +/- 1.6, P < .001), Err (36.2% +/- 10.9 vs 44.4% +/- 9.9, P = .006) and Ell (-12.9% +/- 2.1 vs -15.5% +/- 1.6, P < .001) compared with the control patients. Finally, DM was independently associated with Ecc (P < .001), Err (P = .05) and Ell (P = .01) after adjustment for age, sex, hypertension, body mass index, and left ventricular mass.Conclusion: Cine DENSE, a motion-encoding MR imaging technique for myocardial strain assessment with high spatial resolution, appears to be useful in the identification of subclinical myocardial dysfunction in patients with DM.