bubble50 DH Freelance 中翻英 英翻中

Abstract

摘要

Purpose: To prospectively determine whether diffusion-weighted cardiac MR imaging (DWI) is feasible and to determine cardiac DWI patterns in patients with acute myocarditis, by comparison with delayed-enhancement (DE) cardiac magnetic resonance (CMR) sequences.

目的：藉由與心臟核磁共振（CMR）延遲顯影（DE）的比較，前瞻性地確定心臟核磁共振擴散加權成像（DWI）是否可行，以及測定急性心肌炎患者的心臟核磁共振擴散加權成像模式。

Method: Fifty-eight consecutive patients referred for CMR with a clinical presentation suggestive of acute myocarditis were included. Rest MR examinations included DWI, black-blood fat-suppressed T2-weighted, first-pass perfusion, and DE sequences. Abnormal DWI areas were matched to abnormal DE areas. The apparent diffusion coefficient (ADC) was measured in involved areas and compared to remote normal areas.

方法：連續58例轉介至CMR的患者，其表現出包含急性心肌炎在內的臨床表現。靜態核磁共振檢查包括DWI、黑血脂肪抑制T2加權、首次灌流和延遲顯影序列。將異常DWI區域與異常DE區域相互匹配。在相關區域測量表觀擴散係數（ADC），並將其與遠端正常區域進行比較。

Result: Qualitative assessment of DWI compared with DE images yielded a sensitivity of 92%. DWI patterns were significantly correlated to DE patterns, with focal or multifocal non-segmental non-subendocardial hyper-signals (DWI, 2.78 ± 0.62 segments vs DE, 3.36 ± 0.63 segments, p = ns), predominantly in an inferolateral location. Qualitative assessment of DWI compared to LGE images yielded a sensitivity of 97% and a specificity of 61%. Segment-by-segment comparison showed a high level of correlation (y = (0.91) x + 0.47, r = 0.9049). The ADC of affected segments vs normal remote myocardium was 74.1 % ± 5.6 %. The absolute ADCs (abnormal DE area 0.00751±0.00042 mm2/s, normal myocardium close to abnormal DE area 0.00824±0.0004 mm2/s, and remote normal myocardium 0.00928±0.00049 mm2/s) and relative ADCs were significantly different between groups (P<0.05) except between abnormal DE area and normal myocardium close to abnormal DE area.

結果：與DE圖像相比，DWI的定性評估產生了92％的敏感度。DWI模式明顯地與DE模式有關，主要在下外側方的位置，具有局部性或多灶性、非分節型、非心內膜下超高信號（DWI 2.78±0.62分段對比DE 3.36±0.63分段，p = ns）。與LGE圖像相比，DWI的定性評估產生了97％的敏感度和61％的特異度。逐段比對下，顯示高度的相關性（y =（0.91）x + 0.47，r = 0.9049）。ADC在受影響的分段與正常遠端心肌對比下為74.1％±5.6％。除了在異常DE區域與接近異常DE區域的正常心肌之外，絕對ADC（異常DE區域為0.00751±0.00042 mm2 / s、接近異常DE區域的正常心肌為0.00824±0.0004 mm2 / s以及遠端正常心肌為0.00928±0.00049 mm2 / s）與相對ADC各組（P < 0.05）之間有著明顯的差異。

Conclusion: Extent of myocardial involvement in myocarditis is larger, using absolute ADC measurements at DWI imaging, than expected at DE enhancement. Moreover, ADC maps should help better understand inflammatory phenomena such as an underestimated extent of lesions by late-enhancement sequences. Hence, this sequence should help better appreciate the real extent of myocardial injury in myocarditis.

結論：在擴散加權成像中使用絕對ADC測量值，對心肌炎中心肌損傷的程度，比在延遲顯影中使用的預期還要大。此外，ADC成像應該有助於更好地了解炎症現象，例如因延遲增強序列而低估病變程度。因此，這個序列應該有助於更好地意識到心肌炎中心肌損傷的真實程度。

Key words關鍵詞

myocarditis, magnetic resonance imaging, diffusion magnetic resonance imaging

心肌炎、核磁共振、擴散磁振影像

Abbreviations

縮詞

DWI: Diffusion-Weighted Imaging, EPI: Echo-Planar Imaging, SSFP: Steady State Free Precession, LV: Left Ventricular, 2D: Two-Dimensional, 3D: Three-Dimensional

DWI：擴散加權成像、EPI：回波平面影像術、SSFP：穩定態自由旋進、LV：左心室、2D：二維、3D：三維