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Application of Multiparametric Quantitative Cardiac Magnetic Resonance for Detection and Monitoring of Myocardial Injury in Patients with Fulminant Myocarditis.

应用多参数定量心脏磁共振检测和监测暴发性心肌炎患者的心肌损伤。

  • 影响因子:2.00
  • DOI:10.1016/j.acra.2020.01.034
  • 作者列表:"Li H","Zhu H","Yang Z","Tang D","Huang L","Xia L
  • 发表时间:2020-03-18
Abstract

RATIONALE AND OBJECTIVES:To investigate whether multiparametric cardiac magnetic resonance (CMR) could detect and monitor inflammatory myocardial alterations in fulminant myocarditis. MATERIALS AND METHODS:Nineteen patients (35 ± 14 years, 37% male) with clinical diagnosis of fulminant myocarditis underwent CMR examinations at 3.0T in the acute phase and at 3-months follow up. The control group consisted of 19 healthy volunteers. The CMR protocol included cine, black blood T2-weighted imaging, T1 mapping, T2 mapping and late gadolinium enhancement (LGE). Cardiac parameters, such as edema ratio, LGE mass, native T1, T2 and extracellular volume were measured. RESULTS:The left ventricular mass index (67 ± 15 versus 55 ± 12 g/m2, p < 0.05) and interventricular septum thickness (10.4 ± 1.5 versus 8.3 ± 1.8 mm, p < 0.001) in acute stage was significantly higher compared to controls, and normalized at the chronic stage. All quantitative inflammation metrics, including edema ratio, LGE mass, native T1, T2 and extracellular volume were significantly (all p < 0.001) decreased in the follow-up scan, but still higher compared to controls. Compared to the controls, all global strain indices including circumferential, longitudinal and radial strain values were significantly impaired in acute stage (all p < 0.001). Native T1 and T2 values led to excellent diagnostic accuracy for discriminating fulminant myocarditis from healed myocarditis, with AUC of 0.947 and 0.931. CONCLUSION:Multiparametric CMR could detect and monitor inflammation myocardial injuries in patients with fulminant myocarditis. Native T1 and T2 values achieved excellent diagnostic performance in distinguishing acute from healed myocarditis.

摘要

原理和目的: 探讨多参数心脏磁共振 (CMR) 能否检测和监测暴发性心肌炎的炎性心肌改变。 材料和方法: 19 例临床诊断为暴发性心肌炎的患者 (35 ± 14 岁,37% 为男性) 在急性期 3.0T 和随访 3 个月时进行 CMR 检查。对照组为 19 例健康志愿者。CMR 方案包括电影、黑血 T2-weighted 成像、 T1 标测、 T2 标测和晚期钆增强 (LGE)。测量心脏参数,如水肿比、 LGE 质量、天然 T1 、 T2 和细胞外体积。 结果: 左室重量指数 (67 ± 15 比 55 ± 12g/m2,p <0.05) 和室间隔厚度 (10.4 ± 1.5 比 8.3 ± 1.8毫米,p <0.001) 急性期与对照组相比显著较高,慢性期正常化。所有定量炎症指标,包括水肿比率、 LGE 质量、自然 T1 、 T2 和细胞外体积在随访扫描中显著降低 (均 p <0.001),但与对照组相比仍然较高。与对照组相比,急性期包括圆周、纵向和径向应变值在内的所有整体应变指数均显著受损 (均 p <0.001)。天然 T1 和 T2 值对区分暴发性心肌炎和治愈心肌炎具有极好的诊断准确性,AUC 分别为 0.947 和 0.931。 结论: 多参数 CMR 可检测和监测暴发性心肌炎患者的炎症心肌损伤。天然 T1 和 T2 值在区分急性和治愈心肌炎方面取得了优异的诊断性能。

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影响因子:4.69
发表时间:2020-01-07
DOI:10.1186/s12968-019-0590-z
作者列表:["Yao-Dan Liang","Yuan-Wei Xu","Wei-Hao Li","Ke Wan","Jia-Yu Sun","Jia-Yi Lin","Qing Zhang","Xiao-Yue Zhou","Yu-Cheng Chen"]

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影响因子:4.69
发表时间:2020-01-05
DOI:10.1186/s12968-019-0589-5
作者列表:["Yingxia Yang","Gang Yin","Yong Jiang","Lei Song","Shihua Zhao","Minjie Lu"]

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