标题：定量CMR参数对急性心肌炎诊断的增量价值研究

      作者：牛永超 1，周芳 1，赵丹丹 1，徐雅慧 1，张勇 2    1.新乡市中心医院(新乡市心脏病影像医学重点实验室)磁共振室，河南 新乡 453000；2.郑州大学第一附属医院磁共振科，河南 郑州 450000

      卷次： 2024年35卷14期

      【摘要】 目的 探究定量心脏磁共振(CMR)参数对急性心肌炎诊断的增量价值。方法 选取2021年12月至2023年12月新乡市中心医院收治的120例急性心肌炎患者(急性心肌炎组)进行回顾性研究，另按2∶1比例选取本院体检健康者60例作为对照组，比较两组受检者的定量CMR参数，通过受试者工作特征曲线(ROC)分析定量CMR参数诊断急性心肌炎的价值效能，并对定量CMR参数进行中位数划分，分析定量CMR参数增量诊断急性心肌炎的价值。结果 急性心肌炎组患者T1弛豫时间、T2信号强度比、早期强化率明显高于对照组，差异均有统计学意义(P<0.05)；ROC分析结果显示，T1弛豫时间、T2信号强度比、早期强化率诊断急性心肌炎的曲线下面积(AUC)分别为0.783、0.798、0.644。急性心肌炎组患者T1弛豫时间、T2信号强度比、早期强化率值的中位数分别为1 310.5 ms、2%、3.51%。按中位数将其划分为T1弛豫时间≥1 310.5 ms亚组，T1弛豫时间<1 310.5 ms亚组；T2信号强度比≥2%亚组，T2信号强度比<2%亚组；早期强化率值≥3.51%亚组，早期强化率<3.51%亚组。ROC分析结果显示，在T1弛豫时间≥1 310.5 ms亚组、T2信号强度比≥2%亚组、早期强化率值≥3.51%亚组中T1弛豫时间、T2信号强度比、早期强化率值诊断急性心肌炎的价值较好，AUC分别为0.979、0.959、0.999。结论 定量CMR参数诊断急性心肌炎均具有一定价值，对定量CMR参数进行增量划分后其诊断急性心肌炎价值更高。
      【关键词】 急性心肌炎；定量心脏磁共振参数；增量；诊断价值
      【中图分类号】 R542.2+1 【文献标识码】 A 【文章编号】 1003—6350（2024）14—2056—05

Incremental value of quantitative CMR parameters in the diagnosis of acute myocarditis.
NIU Yong-chao 1, ZHOUFang 1, ZHAO Dan-dan 1, XU Ya-hui 1, ZHANG Yong 2. 1. Magnetic Resonance Room, Xinxiang Central Hospital (XinxiangKey Laboratory of Cardiology Imaging Medicine), Xinxiang 453000, Henan, CHINA; 2. Department of Magnetic Resonance,the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, CHINA
【Abstract】 Objective To investigate the incremental value of quantitative cardiac magnetic resonance (CMR)parameters for the diagnosis of acute myocarditis. Methods A total of 120 patients with acute myocarditis admitted toXinxiang Central Hospital from December 2021 to December 2023 were selected for retrospective study (acute myocar-ditis group), and another 60 healthy people undergoing physical examination in the hospital were selected as the controlgroup, according to the ratio of 2:1. The two groups were compared in terms of quantitative CMR parameters, and the ef-ficacy of quantitative CMR parameters for diagnosing acute myocarditis was analyzed through receiver operating charac-teristic (ROC) curves. The patients were further divided by the median of the quantitative CMR parameters, and the val-ue of quantitative CMR parameter increment in diagnosing acute myocarditis was analyzed. Results The T1 relaxationtime, T2 signal intensity ratio, and early intensification rate were significantly higher in the acute myocarditis group thanin the control group (P<0.05). ROC curve analysis showed that the area under the curve of T1 relaxation time, T2 signalintensity ratio, and early enhancement rate for the diagnosis of acute myocarditis were 0.783, 0.798, and 0.644, respec-tively. The median values of T1 relaxation time, T2 signal intensity ratio, and early enhancement rate values in the acutemyocarditis group were 1 310.5 ms, 2%, and 3.51%, respectively. According to the median of the quantitative CMR pa-rameters, the patients were divided into T1 relaxation time≥1 310.5 ms subgroup and T1 relaxation time<1 310.5 ms sub-group; T2 signal intensity ratio≥2% subgroup and T2 signal intensity ratio<2% subgroup; early reinforcement rate≥3.51% and early reinforcement rate<3.51% subgroup. ROC curve analysis showed that T1 relaxation time, T2 signal intensi-ty ratio, and early enhancement rate had better diagnostic value for acute myocarditis in the T1 relaxation time≥1 310.5 mssubgroup, T2 signal intensity ratio≥2% subgroup, and early reinforcement rate≥3.51%, with the AUC of 0.979, 0.959,and 0.999, respectively. Conclusion Quantitative CMR parameters are of great value in diagnosing acute myocarditis,and the incremental division of quantitative CMR parameters has a higher value in diagnosing acute myocarditis
      【Key words】 Acute myocarditis; Quantitative cardiac magnetic resonance parameters; Incremental; Diagnostic value