Cardiovascular magnetic resonance T2 mapping detects myocardial edema in patients with chronic dilated cardiomyopathy
Cardiovascular magnetic resonance T2 mapping detects myocardial edema in patients with chronic dilated cardiomyopathy
复制标题
心血管磁共振T2图谱检测慢性扩张型心肌病患者心肌水肿
DOI：
10.1186/1532-429x-14-s1-o29
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发表时间：
2012-02-01
影响因子：
6.4
通讯作者：
Pennell DJ
中科院分区：
文献类型：
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作者：
He T;Gulati A;Jabbour A;Ismail TF;Feng Y;Ismail N;Gonçalves C;Brown T;Firmin DN;Prasad SK;Pennell DJ
研究背景T2加权STIR成像显示，慢性扩张型心肌病（DCM）患者存在心肌水肿，这是心肌炎症的替代指标。然而，STIR成像容易出现运动伪影以及与心动周期定时和线圈灵敏度相关的问题。我们假设，一种新的定量CMR T2映射技术将提供一个可靠的和可重复的措施，用于检测心肌水肿在慢性非缺血性DCM. MethodsConcretiveDCM患者的疾病持续时间大于3个月，年龄/性别匹配的健康志愿者前瞻性招募。排除标准包括冠状动脉疾病、全身炎症性疾病、急性心肌炎或心脏生物标志物升高。使用T2准备的单次激发SSFP读数[1]采集心室中短轴切片（1.5 T MRI扫描仪; Siemens Avanto，德国），以生成三个T2加权图像，T2准备时间不同（0 ms、24 ms和55 ms）。并行成像用于减少采集时间，运动校正用于促进T2时间的准确测量。通过对数转换后使用线性2参数模型拟合指数衰减曲线生成T2图。结果研究了90例DCM患者（年龄52±15岁，男性62例（69%），平均LVEF 41%）和28例健康志愿者（年龄46±12岁，男性18例（64%），平均LVEF 68%）。与健康对照组相比，DCM受试者的心肌T2显著更高（56.3±3.5 vs 53.7±1.7 ms; p< 0.001）。T2具有良好的观察者间变异性（CoV= 1.8%，n= 10）和研究间重复性（CoV= 1.9%，n= 14）。DCM患者的心肌T2时间明显高于健康对照组，提示慢性DCM存在心肌炎症。需要进一步的研究来评估这些发现在DCM人群中的临床和预后影响。
BackgroundGlobal myocardial edema, a surrogate measure of myocardial inflammation, has been reported in patients with chronic dilated cardiomyopathy (DCM) based on T2-weighted STIR imaging. However, STIR imaging is prone to motion artefact and issues related to cardiac cycle timing and coil sensitivity. We hypothesised that a novel quantitative CMR T2 mapping technique would provide a reliable and reproducible measure for the detection of myocardial edema in chronic non-ischemic DCM.MethodsConsecutive DCM patients with disease duration greater than 3 months and age/sex matched healthy volunteers were prospectively enrolled. Exclusion criteria included coronary artery disease, systemic inflammatory disease, acute myocarditis or raised cardiac biomarkers. A mid-ventricular short axis slice was acquired (1.5 T MRI scanner; Siemens Avanto, Germany) using a T2-prepared single-shot SSFP readout [1] to generate three T2-weighted images with different T2 preparation times (0 ms, 24 ms, and 55 ms). Parallel imaging was used to reduce the acquisition time and motion-correction applied to facilitate accurate measurement of the T2 times. T2 maps were generated by fitting the exponential decay curve using a linear 2-parameter model after logarithmic transformation. Interobserver variability and interstudy reproducibility were assessed and expressed as coefficient of variation (CoV).ResultsNinety DCM (age 52±15 yrs, male 62 (69%), mean LVEF 41%) and 28 healthy volunteers (age 46±12 yrs, male 18 (64%), mean LVEF 68%) were studied. Subjects with DCM had a significantly higher myocardial T2 compared to healthy controls (56.3±3.5 vs 53.7±1.7 ms; p< 0.001). T2 had good interobserver variability (CoV= 1.8%, n= 10) and interstudy reproducibility (CoV= 1.9%, n= 14).ConclusionsQuantitative T2 mapping is highly reproducible. Myocardial T2 times are significantly higher in DCM patients than those in healthy controls, suggesting that myocardial inflammation is present in chronic DCM. Further studies are needed to assess the clinical and prognostic impact of these findings in the DCM population.