心脏MR特征追踪技术定量评估肺动脉高压患者右心室心肌应变的可行性研究

    Quantitative assessment of right ventricular myocardial strain in pulmonary hypertension using cardiac magnetic resonance feature tracking: a feasibility study

      摘要
    • 摘要:
      目的 评价心脏磁共振特征追踪（CMR-FT）技术用于定量评估肺动脉高压（PH）患者右心室（RV）心肌应变的可行性。
      方法 对22例PH患者和20例健康受试者进行CMR检查。通过CVI42软件测量RV整体（Global）、基底部（Basal）、中间部（Mid）、心尖部（Apical）的心肌应变指标，包括峰值纵向应变（LS）、峰值周向应变（CS）和峰值径向应变（RS）。对两组RV心肌应变参数的差异进行统计分析，包括右心室射血分数（RVEF）、右心室舒张末期容积（RVEDV/BSA）、RV收缩末期容积指数（RVESV/BSA）、每搏输出量指数（SV/BSA）、舒张期心肌质量指数（Diastolic MyoMass/BSA）、收缩期心肌质量指数（Systolic MyoMass/BSA），同时进行受试者操作特征（ROC）分析，以评估所有应变参数的临床诊断效能。
      结果 与对照组比较，PH组RVEF、SV/BSA均降低；RVEDV/BSA、RVESV/BSA、Diastolic MyoMass/BSA、Systolic MyoMass/BSA均升高（均P <0.01）。PH组RSBasal、RSMid、RSGlobal均降低（均P<0.01），CSMid、CSGlobal绝对值均降低（均P<0.05）, CSApical、LSMid、LSApical和LSGlobal绝对值均降低（均P<0.01）；ROC曲线分析显示RSGlobal、CSGlobal、LSGlobal、RSBasal、RSMid、CSMid、CSApical、LSMid、LSApical是PH患者的预测因子，而LSApical有最大的诊断效能（截断值=−15.15%，AUC=0.92，灵敏度=0.773，特异度=0.95）。
      结论 RV 心肌应变参数有可能预测 PH 患者的早期 RV 功能障碍，并且可以反映 PH 患者的进展。

       

      Abstract:
      AIM  To evaluate the feasibility of cardiac magnetic resonance feature tracking (CMR-FT) for quantitatively assessing right ventricular (RV) myocardial strain in patients with pulmonary hypertension (PH).
      METHODS  A total of 22 PH patients and 20 healthy controls underwent CMR imaging. Using CVI42 software, CMR-FT was applied to measure peak longitudinal strain (LS), peak circumferential strain (CS), and peak radial strain (RS) across basal, mid, apical, and global segments of RV. Differences in strain parameters between the two groups were analyzed using SPSS 26.0, and receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic utility of these strain parameters.
      RESULTS  Compared with the control group, the PH group showed a decrease in RVEF and SV/BSA; RVEDV/BSA, RVESV/BSA, Diastolic MyoMass/BSA, and Systolic MyoMass/BSA all increased (all P<0.01). The PH group showed a decrease in RSBasal, RSMid, and RSGlobal (all P<0.01), as well as a decrease in the absolute values of CSMid and CSGlobal (all P<0.05), The absolute values of CSApical, LSMid, LSApical, and LSGlobal all decreased (all P<0.01); ROC curve analysis showed that RSGlobal, CSGlobal, LSGlobal, RSBasal, RSMid, CSMid, CSApical, LSMid, and LSApical were predictive factors for PH patients, with LSApical having the highest diagnostic efficacy (cut-off value=−15.15%, AUC=0.92, sensitivity=0.773, specificity=0.95).
      CONCLUSION  RV myocardial strain parameters, as measured by CMR-FT, effectively reflect disease progression in PH patients and may serve as potential indicators of early RV dysfunction.

       

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