Diagnostic performance and relationships of structural parameters and strain components for the diagnosis of cardiac amyloidosis with MRI.

IF 4.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Diagnostic and Interventional Imaging Pub Date : 2024-09-03 DOI:10.1016/j.diii.2024.08.002

Youssef Zaarour, Islem Sifaoui, Haifa Remili, Mounira Kharoubi, Amira Zaroui, Thibaud Damy, Jean-François Deux

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引用次数: 0

Abstract

Purpose: The purpose of this study was to evaluate the diagnostic performance and relationships of cardiac MRI structural parameters and strain components in patients with cardiac amyloidosis (CA) and to estimate the capabilities of these variables to discriminate between CA and non-amyloid cardiac hypertrophy (NACH).

Materials and methods: Seventy patients with CA (56 men; mean age, 76 ± 10 [standard deviation] years) and 32 patients (19 men; mean age, 63 ± 10 [standard deviation] years) with NACH underwent cardiac MRI. Feature tracking (FT) global longitudinal strain (GLS), radial strain (GRS), circumferential strain (GCS), strain AB ratio (apical strain divided by basal strain), myocardial T1, myocardial T2 and extracellular volume (ECV) were calculated. Comparisons between patients with CA and those with NACH were made using Mann-Whitney rank sum test. The ability of each variable to discriminate between CA and NACH was estimated using area under the receiver operating characteristic curve (AUC).

Results: Patients with CA had higher median GLS (-7.0% [Q1, -9.0; Q3, -5.0]), higher median GCS (-12.0% [Q1, -15.0; Q3, -9.0]), and lower median GRS (16.5% [Q1, 13.0; Q3, 23.0]) than those with NACH (-9.0% [Q1, -11.0; Q3, -8.0]; -17.0% [Q1, -20.0; Q3, -14.0]; and 25.5% [Q1, 16.0; Q3, 31.5], respectively) (P < 0.001 for all). Median myocardial T1 and ECV were significantly higher in patients with CA (1112 ms [Q1, 1074; Q3, 1146] and 47% [Q1, 41; Q3, 55], respectively) than in those with NACH (1056 ms [Q1, 1011; Q3, 1071] and 28% [Q1, 26; Q3, 30], respectively) (P < 0.001). Basal ECV showed the best performance for the diagnosis of CA (AUC = 0.975; 95% confidence interval [CI]: 0.947-1). No differences in AUC were found between AB ratio of GRS (0.843; 95% CI: 0.768-0.918) and basal myocardial T1 (0.834; 95% CI: 0.741-0.928) for the diagnosis of CA (P = 0.81). The combination of the AB ratio of FT-GRS and basal myocardial T1 had a diagnostic performance not different from that of basal ECV (P = 0.06).

Conclusion: ECV outperforms FT-strain for the diagnosis of CA with cardiac MRI. The AB ratio of FT-GRS associated with myocardial T1 provides diagnostic performance similar to that achieved by ECV.

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利用磁共振成像诊断心脏淀粉样变性病的结构参数和应变成分的诊断性能和关系。

目的：本研究旨在评估心脏淀粉样变性（CA）患者心脏磁共振成像结构参数和应变成分的诊断性能和关系，并估计这些变量区分CA和非淀粉样变性心脏肥大（NACH）的能力：70名CA患者（56名男性；平均年龄为76 ± 10 [标准差]岁）和32名NACH患者（19名男性；平均年龄为63 ± 10 [标准差]岁）接受了心脏磁共振成像检查。计算了特征追踪（FT）全局纵向应变（GLS）、径向应变（GRS）、周向应变（GCS）、应变 AB 比值（心尖应变除以基底应变）、心肌 T1、心肌 T2 和细胞外容积（ECV）。CA 患者与 NACH 患者之间的比较采用 Mann-Whitney 秩和检验。使用接收者操作特征曲线下面积（AUC）估算每个变量区分CA和NACH的能力：结果：CA 患者的 GLS 中位数较高（-7.0% [Q1, -9.0; Q3, -5.0]），GCS 中位数较高（-12.0% [Q1, -15.0; Q3, -9.0]），GRS 中位数较低（16.5% [Q1, 13.分别为-9.0% [Q1, -11.0; Q3, -8.0]；-17.0% [Q1, -20.0; Q3, -14.0]；和 25.5% [Q1, 16.0; Q3, 31.5]）。CA 患者的心肌 T1 和 ECV 中位数（分别为 1112 ms [Q1, 1074; Q3, 1146] 和 47% [Q1, 41; Q3, 55]）明显高于 NACH 患者（分别为 1056 ms [Q1, 1011; Q3, 1071] 和 28% [Q1, 26; Q3, 30]）（P < 0.001）。基础 ECV 在诊断 CA 方面表现最佳（AUC = 0.975；95% 置信区间 [CI]：0.947-1）。GRS的AB比值（0.843；95% CI：0.768-0.918）和基础心肌T1（0.834；95% CI：0.741-0.928）在诊断CA方面的AUC没有差异（P = 0.81）。FT-GRS和基础心肌T1的AB比值组合的诊断效果与基础ECV没有差异（P = 0.06）：结论：在心脏磁共振成像诊断CA方面，ECV优于FT-应变。FT-GRS与心肌T1的AB比值具有与ECV相似的诊断性能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostic and Interventional Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

8.50

自引率

29.10%

发文量

126

审稿时长

11 days

期刊介绍： Diagnostic and Interventional Imaging accepts publications originating from any part of the world based only on their scientific merit. The Journal focuses on illustrated articles with great iconographic topics and aims at aiding sharpening clinical decision-making skills as well as following high research topics. All articles are published in English. Diagnostic and Interventional Imaging publishes editorials, technical notes, letters, original and review articles on abdominal, breast, cancer, cardiac, emergency, forensic medicine, head and neck, musculoskeletal, gastrointestinal, genitourinary, interventional, obstetric, pediatric, thoracic and vascular imaging, neuroradiology, nuclear medicine, as well as contrast material, computer developments, health policies and practice, and medical physics relevant to imaging.