3.0T CMR 定量技术诊断急性病毒性心肌炎 效能及评估短期预后的价值

doi:10.3969/j.issn.1006⁃5725.2023.09.019

摘要/Abstract

摘要：

目的探讨 3.0T 心脏磁共振（CMR）定量技术诊断急性病毒性心肌炎（AVM）效能及评估短期预后的价值。方法选取衡水市人民医院 2019 年 1 月至 2021 年 8 月疑似 AVM 患者 115 例，以临床诊断为参照，分为 AVM 组与非 AVM 组，评价 3.0T CMR 定量参数［T2 比值、早期强化成像（EGE）比值、延迟强化成像（LGE）体积、LGE 占左心室质量百分比］对 AVM 的诊断价值，并对 AVM 患者随访 3 个月，统计预后情况，对比不同预后患者 3.0T CMR 定量参数，分析各参数与预后的关系。结果临床诊断显示，确诊为 AVM 患者 81 例，非 AVM 患者 34 例；AVM 组 T2 比值、EGE 比值、LGE 体积、LGE 占左心室质量百分比高于非 AVM 组（P < 0.05）；T2 比值、EGE 比值、LGE 体积、LGE 占左心室质量百分比联合诊断 AVM 的 AUC 0.908 （95%CI：0.840～0.954）明显大于各参数单一诊断（均 P < 0.05）；以 ROC 曲线获取的最截断值为界，分为阳性与阴性，T2 比值、EGE比值、LGE体积、LGE占左心室质量百分比阳性患者 AVM 发生风险是阴性患者的 8.815 倍、2.938 倍、2.183 倍、4.337 倍；随访 3 个月，AVM 组预后良好 67 例，预后不良 14 例，预后不良患者 T2 比值、EGE 比值、LGE 体积、LGE 占左心室质量百分比高于预后良好患者（P < 0.05）；T2 比值、EGE 比值、 LGE 体积、LGE 占左心室质量百分比与 AVM 短期预后呈负相关（P < 0.05）。结论 3.0T CMR 定量参数可作为临床诊断 AVM 的可靠影像学检查方式，还能用于短期预后评估中，可为临床诊治提供有效的客观信息。

关键词: 急性病毒性心肌炎, 3.0T心脏磁共振定量技术, 诊断价值, 短期预后

Abstract:

Objective To investigate the value of quantitative 3.0T cardiac magnetic resonance（CMR） techniques for diagnosing the efficacy of acute viral myocarditis（AVM）and assessing short⁃term prognosis. Meth⁃ ods 115 patients with suspected AVM from January 2019 to August 2021 in our hospital were selected and divid⁃ ed into AVM and non ⁃AVM groups with reference to clinical diagnosis，to evaluate the diagnostic value of 3.0T CMR quantitative parameters［T2 ratio，early intensification imaging（EGE）ratio，delayed intensification imaging （LGE）volume，and LGE as a percentage of left ventricular mass］for AVM，and patients with AVM were Patients with AVM were followed up for 3 months，prognosis was counted，3.0T CMR quantitative parameters were com⁃ pared in patients with different prognosis，and the relationship between each parameter and prognosis was analyzed. Results Clinical diagnosis showed that 81 patients with confirmed AVM and 34 patients with non⁃AVM；T2 ra⁃ tio，EGE ratio，LGE volume，and LGE as a percentage of LV mass were higher in the AVM group than in the non⁃ AVM group（P < 0.05）；the AUC of T2 ratio，EGE ratio，LGE volume，and LGE as a percentage of LV mass for the combined diagnosis of AVM was 0.908（95% CI：0.840 to 0.954）was significantly greater than the single diag⁃ nosis of each parameter（all P < 0.05）. Using the most truncated value obtained from the ROC curve as the bound⁃ ary，divided into positive and negative，the risk of AVM occurrence was 8.815 times，2.938 times，2.183 times， and 4.337 times higher in patients with positive T2 ratio，EGE ratio，LGE volume，and LGE as a percentage of LV mass than in patients with negative；at 3⁃month follow ⁃up，the AVM group had a good prognosis in 67 cases，a poor prognosis in 14 cases，and a poor prognosis in T2 ratio，EGE ratio，LGE volume，and percentage of LGE to LV mass were higher than those of patients with good prognosis（P < 0.05）；T2 ratio，EGE ratio，LGE volume， and percentage of LGE to LV mass were negatively correlated with short⁃term prognosis of AVM（P < 0.05）.Conclusion The 3.0T CMR quantitative technique can be used as a reliable imaging modality for clinical diagno⁃ sis of AVM and also for short⁃term prognostic assessment，which can provide effective objective information for clin⁃ ical diagnosis and treatment.

Key words: Acute viral myocarditis, 3.0T quantitative cardiac magnetic resonance technique, diag? nostic value, short?term prognosis

李楠康志雷 . 3.0T CMR 定量技术诊断急性病毒性心肌炎效能及评估短期预后的价值 [J]. 实用医学杂志, 2023, 39(9): 1169-1173.

LI Nan, KANG Zhilei. . The value of 3.0T CMR quantitative technique for diagnosing the efficacy of acute viral myocarditis and as⁃ sessing short⁃term prognosis [J]. The Journal of Practical Medicine, 2023, 39(9): 1169-1173.

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