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目的:应用心脏磁共振心肌首过灌注技术(CMR-MPI)对急性病毒性心肌炎(AVM)进行定量分析,并获得灌注曲线下面积比与肌钙蛋白(cTn)T的关系。方法:纳入31例AVM患者(AVM组)与20例健康志愿者(对照组)。两组行3.0T心脏磁共振扫描,测定CMR-MPI灌注参数(曲线下面积比、达峰时间及相对峰值信号)和cTnT浓度。采用Spearman等级相关对CMR-MPI曲线下面积和血清cTnT浓度进行统计分析。结果:曲线下面积比:灌注正常区、减低区及缺损区分别为(52.80±3.05)%、(37.64±4.87)%、(26.23±2.29)%,P<0.05;相对峰值信号强度分别为(44.91±3.16)%、(33.96±4.98)%、(29.94±3.75)%,P<0.05;达峰时间分别为(34.22±4.89)s、(37.85±7.51)s、(38.24±6.06)s,P<0.05。AVM组与对照组血清cTnT浓度分别为(0.578±1.127)ng/ml、(0.011±0.006)ng/ml,P<0.05。Spearman等级相关分析AVM组CMR-MPI曲线下面积比与血清cTnT浓度的关系,rs=-0.557,P<0.05。结论:CMR-MPI可定量评估AVM心肌缺血程度,AVM患者血清cTnT浓度与CMR-MPI曲线下面积比呈负相关,提示AVM心肌微循环障碍和心肌缺血可能是造成或加重心肌细胞损伤及cTnT释放的原因之一。
OBJECTIVE: To quantitatively analyze acute viral myocarditis (AVM) using cardiac magnetic resonance myocardial perfusion (CMR-MPI) and to determine the relationship between the area under the perfusion curve and troponin (cTn) T. Methods: A total of 31 AVM patients (AVM group) and 20 healthy volunteers (control group) were enrolled. Two groups of 3.0T cardiac magnetic resonance scan, CMR-MPI perfusion parameters (area under the curve, peak time and relative peak signal) and cTnT concentration. Spearman rank correlation was used to statistically analyze the area under the CMR-MPI curve and serum cTnT concentration. Results: The area under the curve was (52.80 ± 3.05)%, (37.64 ± 4.87)% and (26.23 ± 2.29)%, respectively, P <0.05. The relative peak signal intensity was 44.91 ± 3.16%, 33.96 ± 4.98% and 29.94 ± 3.75% respectively, P <0.05; the peak time was (34.22 ± 4.89) s, (37.85 ± 7.51) s and (38.24 ± 6.06) s respectively P <0.05. The serum concentrations of cTnT in AVM group and control group were (0.578 ± 1.127) ng / ml and (0.011 ± 0.006) ng / ml respectively, P <0.05. Spearman rank correlation analysis of AVM group CMR-MPI curve under the area ratio and serum cTnT concentration relationship, rs = -0.557, P <0.05. CONCLUSION: CMR-MPI can quantitatively assess the degree of myocardial ischemia in AVM. The negative correlation between the serum cTnT level and the area under CMR-MPI curve in AVM patients suggests that myocardial microcirculation and myocardial ischemia in AVM may cause or aggravate cardiomyocyte injury and One of the reasons cTnT is released.