ĐÁNH GIÁ ĐẶC ĐIỂM HÌNH ẢNH VIÊM CƠ TIM CẤP TRÊN MÁY CỘNG HƯỞNG TỪ 3T TẠI BỆNH VIỆN BẠCH MAI=Assessment Characteristics of Acute Myocarditis by 3-Tesla Cardiac Magnetic Resonance Imaging

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Thùy Liên Lê, Khôi Việt Nguyễn, Ngọc Tráng Nguyễn, Thị Huyền Nguyễn, Đăng Lưu Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.62-69

Bộ sưu tập: Metadata

ID: 486835

Thêm vào giỏ

Đặt vấn đề: Viêm cơ tim cấp (VCTC) là một bệnh cảnh lâm sàng không đặc hiệu. Chẩn đoán lâm sàng và cận lâm sàng viêm cơ tim cấp gồm nhiều tiêu chí khác nhau trong đó chụp cộng hưởng từ tim (MRI tim) có sử dụng tiêu chuẩn Lake Loiuse 2018 mở rộng là một công cụ hữu ích để chẩn đoán viêm cơ tim.Mục tiêu: Đánh giá một cách có hệ thống các thông số hình ảnh MRI tim không xâm lấn trong viêm cơ tim cấp. Phương pháp nghiên cứu: 45 bệnh nhân nghi ngờ VCTC trên lâm sàng được chụp MRI tim. Bệnh nhân khởi phát triệu chứng từ 1 ngày đến 6 tuần. Chụp MRI tim bao gồm các chuỗi xung đánh giá hình thái, chức năng, hình ảnh ngấm thuốc đối quang từ muộn (LGE) và các thông số mapping (T2 mapping, T1 mapping trước tiêm và ECV).Kết quả: Có 45 bệnh nhân nghi ngờ VCTC trên lâm sàng (tuổi trung bình 31,4±11,4 (14-68)
26,7% là nữ) đã được nghiên cứu. Thời gian khởi phát triệu chứng là 6,5±5,9 (1-18) ngày. Thời gian T1 mapping trung bình: 1305,0 ±127,2ms
T2 mapping: 54,07± 10,95ms, ECV: 41,18 ±18,40%, LGE: 75,55%. Độ nhạy của các chuỗi xung: T1 mapping: 97,8%, T2 mapping: 97,8%, ECV: 95,6%, LGE: 75,55%, Lake Louise: 76,5%. Các tổn thương ngấm thuốc muộn (LGE) chủ yếu dạng mảng (52,9%) nằm ở phần dưới ngoại mạc (76.4%) của thành dưới bên vị trí đáy tim (44.4%). Có sự tương quan thuận trung bình giữa T1 mapping vàhs-Troponin T (k=0.452, p=0.006) và giữa T2 mapping với NT-proBNP (k=0.546,p=0.02). Sự đồng thuận cao trong đánh giá vận động vùng trên siêu âm và MRI tim (k=0.789)Kết luận: MRI tim là phương pháp toàn diện cho phép chẩn đoán đáng tin cậy các trường hợp nghi ngờ VCTC trên lâm sàng. Trong số đó, LGE đơn thuần hoặc kết hợp với bản đồ T1, bản đồ T2, ECV là những chuỗi xung hữu ích nhất để chẩn đoán VCTC.Introduction: Acute myocarditis (AM) is a nonspecific clinical condition. Clinical and paraclinical diagnosis of AM includes many different criteria, of which cardiac magnetic resonance imaging (CMR) is a useful tool to diagnose AM.Purpose: Systematically evaluate non-invasive CMR parameters in AM.Methods: 45 patients with clinically suspected AM underwent CMR. Patient onset of symptoms ranges from 1 day to 6 weeks. CMR includes pulse sequences assessing morphology, function, late gadolinium enhancement (LGE) images, and mapping parameters (T2 mapping, native T1 mapping, and ECV).Results: 45 patients with clinically suspected AM (mean age 31.4±11.4 (14-68)
26.7% female). Time to symptoms onset was 6.5±5.9 (1-18) days. Average T1 mapping time: 1305.0 ±127.2ms
T2 mapping: 54.07± 10.95ms, ECV: 41.18 ±18.40%, LGE: 75.55%. Sensitivity of pulse sequences: T1 mapping: 97.8%, T2 mapping: 97.8%, ECV: 95.6%, LGE: 75.55%, Lake Louise: 76.5%. LGE lesions are mainly linear (52.9%) and located in the subepicardial (76.4%) of the inferior lateral wall of the cardiac base (44.4%). There is a moderate positive correlation between T1 mapping and hs-Troponin T (k=0.452, p=0.006) and between T2 mapping and NT-proBNP (k=0.546, p=0.02). High agreement in assessing regional motion on ultrasound and CMR (k=0.789)Conclusion: CMR is a comprehensive method that allows reliable diagnosis of suspected AM clinical. Among them, LGE alone or combined with T1 map, T2 map, and ECV are the most useful pulse sequences to diagnose myocarditis.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR