磁共振T1、T2 mapping技術(shù)定量評價心肌的初步研究
發(fā)布時間：2018-08-03 06:55
【摘要】：目的利用基于改進的Look-Locker快速穩(wěn)態(tài)自由進動飽和恢復(MLLSR)序列的T1mapping技術(shù)和基于多回波快速自旋回波(MEFSE)序列的T2 mapping技術(shù)定量評價心肌梗死患者和健康志愿者左室心肌:(1)探討此兩種技術(shù)臨床應(yīng)用的可行性和可重復性;(2)討論初始T1值、增強后T1值、細胞外間隙(ECV)和T2值定量評價心肌梗死的診斷價值;(3)評價健康志愿者左室不同區(qū)域心肌的初始T1值和T2值以供參考。資料和方法(1)選取符合診斷標準的8例心肌梗死患者行3.0T心臟磁共振Cine電影、T2WI序列、T2 mapping、增強前T1 mapping、首過灌注、造影劑延遲強化和增強后T1mapping序列檢查,分別測量心肌梗死區(qū)域與遠隔正常心肌區(qū)域內(nèi)初始T1值、增強后T1值、ECV值和T2值,并對其進行獨立樣本t檢驗、One-way ANOVA方差分析和ROC曲線分析。(2)對符合入組條件的30例健康志愿者,分別行Cine電影、T2WI序列、T1 mapping和T2 mapping序列掃描,測定感興趣區(qū)內(nèi)初始T1值和T2值,應(yīng)用獨立樣本t檢驗或One-way ANOVA方差分析方法統(tǒng)計分析心肌17節(jié)段及不同供血區(qū)、年齡和性別有無差別。對所測得的初始T1值和T2值進行Bland-Altman一致性分析和Pearson相關(guān)分析。結(jié)果(1)心肌梗死區(qū)域和遠隔正常心肌區(qū)域的初始T1值、增強后T1值、ECV值和T2值均有統(tǒng)計學差異(t=3.752、-2.910、5.029和4.137,P0.01),其值如下:初始T1值,(754.8±273.8)ms和(561.4±152.8)ms;增強后T1值,(438.8±73.6)ms和(506.1±120.0)ms;ECV值,(0.334±0.179)ms和(0.158±0.116)ms;T2值,(81.9±15.7)ms和(65.1±10.0)ms。急性心肌梗死區(qū)域的初始T1、ECV值和T2值高于亞急性、慢性心肌梗死區(qū)域(F=14.210,10.367和12.342,P0.001)。各參數(shù)值在定量評價心肌梗死方面具有較高的敏感度、特異度和準確度。(2)健康志愿者左室17節(jié)段心肌初始T1值和T2值不全相等(P0.01)。心肌平均初始T1值、血池平均初始T1值和心肌平均T2值如下:基底部,(717.6±100.6)ms,(1208.9±224.2)ms,(71.6±7.1)ms;中間部,(773.9±101.2)ms,(1281.2±251.7)ms,(77.3±9.2)ms;心尖部,(955.4±191.1)ms,(1829.6±584.8)ms,(83.0±8.5)ms。心尖部心肌和血池的初始T1值高于中間部和基底部(P0.01),從基底部到心尖部心肌T2值逐漸升高(F=14.245,P0.01)。左前降支、右冠狀動脈及左旋支供血區(qū)心肌初始T1值有統(tǒng)計學差異(F=47.862,P0.01)而心肌T2值無統(tǒng)計學差異(F=1.656,P=0.192)。根據(jù)Bland-Altman一致性分析和Pearson相關(guān)分析得到參數(shù)測量在觀察者間具有良好的一致性。結(jié)論MLLSR T1 mapping和MEFSE T2 mapping技術(shù)在心臟成像中具有較好的可行性和可重復性。此兩種技術(shù)得到的初始T1值、增強后T1值、ECV值和T2值可定量評價心肌梗死,具有較好的臨床應(yīng)用前景。中國健康志愿者中左室心肌初始T1值和T2值存在節(jié)段性差異。
[Abstract]:Objective to quantitatively evaluate the left ventricular myocardium of patients with myocardial infarction and healthy volunteers by using improved T1mapping technology based on improved Look-Locker fast steady free dynamic progressive saturation recovery (MLLSR) sequence and T2 mapping based on multiple echo fast spin echo (MEFSE) sequences: (1) to explore the feasibility and repeatability of these two clinical applications. 2) the initial T1 value, the enhanced T1 value, the extracellular space (ECV) and the T2 value were used to evaluate the diagnostic value of myocardial infarction; (3) to evaluate the initial T1 value and T2 value of the myocardium in the left ventricular region of the healthy volunteers for reference. (1) 8 patients with myocardial infarction, which were in accordance with the diagnostic criteria, were performed 3.0T cardiac MRI Cine film, T2WI sequence, T2. Mapping, pre enhanced T1 mapping, first over perfusion, delayed enhancement and enhanced T1mapping sequence examination, the initial T1 values in the myocardial infarction region and the normal myocardial region were measured respectively, the T1 value, the ECV value and the T2 value were enhanced, and the independent sample t test, One-way ANOVA variance analysis and ROC curve analysis were carried out. (2) conforms to the entry group. 30 healthy volunteers were performed Cine film, T2WI sequence, T1 mapping and T2 mapping sequence scanning. The initial T1 value and T2 value in the region of interest were measured. Independent sample t test or One-way ANOVA variance analysis was used to analyze the 17 segments of the myocardium and the different blood supply regions. Bland-Altman consistency analysis and Pearson correlation analysis. Results (1) the initial T1 value of myocardial infarction area and distant normal myocardial region, enhanced T1 value, ECV value and T2 value were statistically different (t=3.752, -2.910,5.029 and 4.137, P0.01), the values were as follows: initial T1 value, (754.8 + 273.8) MS and (561.4 + 152.8) MS; (438.8 +) 73.6) ms and (506.1 + 120) MS; ECV value, (0.334 + 0.179) ms and (0.158 + 0.116) MS; T2 value, (81.9 + 15.7) ms and (65.1 +) Ms. acute myocardial infarction region, initial T1, ECV value and T2 value higher than subacute, chronic myocardial infarction region (F=14.210,10.367 and 12.342,). Degree, specificity and accuracy. (2) the initial T1 value and T2 value of the left ventricular myocardium in the healthy volunteers were not all equal (P0.01). The average initial T1 value of the myocardium, the mean initial T1 value of the blood pool and the average T2 value of the myocardium were as follows: the basal part, (717.6 + 100.6) ms, (1208.9 + 224.2) ms, (71.6 + 7.1) MS; the middle part, (773.9 + 101.2) ms, (1281.2 + 251.7) ms, (77.3 + 9.2) MS; heart (77.3 + 9.2) MS; heart The apex, (955.4 + 191.1) ms, (1829.6 + 584.8) ms, (83 + 8.5) Ms., the initial T1 value of the apical myocardium and blood pool was higher than that in the middle and basal parts (P0.01), and the T2 value increased gradually from the basal part to the apical myocardium (F=14.245, P0.01). The left anterior descending branch, the right coronary artery and the left branch blood supply region had statistical difference (F=47.862, P0.01). The T2 values of muscle were not statistically different (F=1.656, P=0.192). According to Bland-Altman consistency analysis and Pearson correlation analysis, the parameters measured were good consistency among the observers. Conclusion MLLSR T1 mapping and MEFSE T2 mapping technology have good feasibility and repeatability in cardiac imaging. The initial T1 values obtained by these two techniques, The enhanced T1 value, ECV value and T2 value can quantitatively evaluate the myocardial infarction and have a good clinical prospect. There is a segmental difference between the initial T1 and T2 values in the left ventricular myocardium in Chinese healthy volunteers.
【學位授予單位】：第四軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R445.2;R542.22
本文編號：2160917
[Abstract]:Objective to quantitatively evaluate the left ventricular myocardium of patients with myocardial infarction and healthy volunteers by using improved T1mapping technology based on improved Look-Locker fast steady free dynamic progressive saturation recovery (MLLSR) sequence and T2 mapping based on multiple echo fast spin echo (MEFSE) sequences: (1) to explore the feasibility and repeatability of these two clinical applications. 2) the initial T1 value, the enhanced T1 value, the extracellular space (ECV) and the T2 value were used to evaluate the diagnostic value of myocardial infarction; (3) to evaluate the initial T1 value and T2 value of the myocardium in the left ventricular region of the healthy volunteers for reference. (1) 8 patients with myocardial infarction, which were in accordance with the diagnostic criteria, were performed 3.0T cardiac MRI Cine film, T2WI sequence, T2. Mapping, pre enhanced T1 mapping, first over perfusion, delayed enhancement and enhanced T1mapping sequence examination, the initial T1 values in the myocardial infarction region and the normal myocardial region were measured respectively, the T1 value, the ECV value and the T2 value were enhanced, and the independent sample t test, One-way ANOVA variance analysis and ROC curve analysis were carried out. (2) conforms to the entry group. 30 healthy volunteers were performed Cine film, T2WI sequence, T1 mapping and T2 mapping sequence scanning. The initial T1 value and T2 value in the region of interest were measured. Independent sample t test or One-way ANOVA variance analysis was used to analyze the 17 segments of the myocardium and the different blood supply regions. Bland-Altman consistency analysis and Pearson correlation analysis. Results (1) the initial T1 value of myocardial infarction area and distant normal myocardial region, enhanced T1 value, ECV value and T2 value were statistically different (t=3.752, -2.910,5.029 and 4.137, P0.01), the values were as follows: initial T1 value, (754.8 + 273.8) MS and (561.4 + 152.8) MS; (438.8 +) 73.6) ms and (506.1 + 120) MS; ECV value, (0.334 + 0.179) ms and (0.158 + 0.116) MS; T2 value, (81.9 + 15.7) ms and (65.1 +) Ms. acute myocardial infarction region, initial T1, ECV value and T2 value higher than subacute, chronic myocardial infarction region (F=14.210,10.367 and 12.342,). Degree, specificity and accuracy. (2) the initial T1 value and T2 value of the left ventricular myocardium in the healthy volunteers were not all equal (P0.01). The average initial T1 value of the myocardium, the mean initial T1 value of the blood pool and the average T2 value of the myocardium were as follows: the basal part, (717.6 + 100.6) ms, (1208.9 + 224.2) ms, (71.6 + 7.1) MS; the middle part, (773.9 + 101.2) ms, (1281.2 + 251.7) ms, (77.3 + 9.2) MS; heart (77.3 + 9.2) MS; heart The apex, (955.4 + 191.1) ms, (1829.6 + 584.8) ms, (83 + 8.5) Ms., the initial T1 value of the apical myocardium and blood pool was higher than that in the middle and basal parts (P0.01), and the T2 value increased gradually from the basal part to the apical myocardium (F=14.245, P0.01). The left anterior descending branch, the right coronary artery and the left branch blood supply region had statistical difference (F=47.862, P0.01). The T2 values of muscle were not statistically different (F=1.656, P=0.192). According to Bland-Altman consistency analysis and Pearson correlation analysis, the parameters measured were good consistency among the observers. Conclusion MLLSR T1 mapping and MEFSE T2 mapping technology have good feasibility and repeatability in cardiac imaging. The initial T1 values obtained by these two techniques, The enhanced T1 value, ECV value and T2 value can quantitatively evaluate the myocardial infarction and have a good clinical prospect. There is a segmental difference between the initial T1 and T2 values in the left ventricular myocardium in Chinese healthy volunteers.
【學位授予單位】：第四軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R445.2;R542.22
【共引文獻】
相關(guān)期刊論文 前1條
1 Yuanbo Feng;Zhan-Long Ma;Feng Chen;Jie Yu;Marlein Miranda Cona;Yi Xie;Yue Li;Yicheng Ni;;Bifunctional staining for ex vivo determination of area at risk in rabbits with reperfused myocardial infarction[J];World Journal of Methodology;2013年03期
相關(guān)博士學位論文 前1條
1 于靜;能譜CT定量評估豬急性缺血—再灌注型MI[D];天津醫(yī)科大學;2014年
相關(guān)碩士學位論文 前1條
1 王興蘭;定量T_2-mapping在心臟成像中的應(yīng)用研究進展[D];重慶醫(yī)科大學;2014年
，本文編號：2160917
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