健康成人在1.5T心脏磁共振扫描下的T<sub>1</sub>、T<sub>2</sub>及ECV正常值的测定

马丽; 吴月; 段炼; 包梦圆; 吴永顺; 邢艳

doi:10.16766/j.cnki.issn.1674-4152.003558

健康成人在1.5T心脏磁共振扫描下的T₁、T₂及ECV正常值的测定

doi: 10.16766/j.cnki.issn.1674-4152.003558

马丽¹,
吴月²,
段炼³,
包梦圆²,
吴永顺²,
邢艳^2, ,

1.
新疆维吾尔自治区人民医院综合保健内科一病区，新疆乌鲁木齐 830001
2.
新疆医科大学第一附属医院影像中心，新疆乌鲁木齐 830011
3.
新疆心脑血管病医院放射科，新疆乌鲁木齐 830000

基金项目:

自治区科技支疆项目计划 2021E02067

详细信息

通讯作者:
邢艳，E-mail：xingyanzwb@sina.com

中图分类号: R445.2R540.4
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出版历程
- 收稿日期: 2024-02-28
- 网络出版日期: 2024-07-22

Normal values of T₁, T₂, and ECV in 1.5T cardiovascular magnetic resonance scanning in health adults

1.
First Department of Comprehensive Internal Medicine, People' s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830001, China

摘要

摘要: 目的本研究旨在勾画正常成人心肌，分析T₁、T₂及细胞外间质容积分数(ECV)的范围，并建立适用于新疆地区的心血管磁共振成像(CMR)参数定量技术参考值。方法收集并分析2023年3—9月在新疆医科大学第一附属医院接受CMR检查的122名健康成人。采用Cvi软件进行心肌勾画，分析心功能参数、T₁、T₂及ECV值在不同性别、年龄及民族之间的差异。结果整体心肌的T₁平均值为(1 090±74)ms，T₂平均值为(53.0±1.7)ms，ECV平均值为(28.3±3.3)%。女性T₁值[(1 121±78)ms vs.(1 065±61)ms, P＜0.05]、T₂值[(53.3±1.4)ms vs. (52.7±1.9)ms, P＜0.05]和ECV值[(29.1±2.9)% vs. (27.7±3.5)%, P＜0.001]高于男性。随着年龄的增长，T₁和ECV值也增高，但差异无统计学意义，基底段T₂值在不同年龄组间差异有统计学意义，整体人群的T₁和T₂值与年龄存在相关性，T₂值的年龄与性别为男性有相关性，T₁和ECV值与年龄无相关性。在民族差异性分析中，少数民族的T₁值明显高于汉族，但T₂和ECV值在组间比较中差异无统计学意义。结论在本研究中，健康成人心肌的T₁、T₂及ECV值在年龄、性别及民族中差异有统计学意义。使用CMR参数定量技术时，有必要对年龄、性别及民族进行校正，有助于临床医师根据本地区参考值更加准确地诊断心脏疾病，确定疾病进展。
- 心脏磁共振成像 /
- 纵向弛豫时间定量成像 /
- 横向弛豫时间定量成像 /
- 细胞外间质容积分数 /
- 正常参考值
Abstract: Objective This study aims to describe normal adult myocardium, analyze the range of T₁, T₂, and ECV, and establish a quantitative technical reference value of cardiovascular magnetic resonance (CMR) parameters suitable for Xinjiang. Methods A total of 122 healthy adults who underwent CMR examination in the First Affiliated Hospital of Xinjiang Medical University from March to September 2023 were collected and analyzed. The myocardial was performed using Cvi software, and the differences in cardiac function parameters, T₁, T₂, and ECV values among different genders, ages, and nationalities were analyzed. Results The average value of T₁, T₂, and ECV of the whole myocardium was (1 090±74) ms, (53.0±1.7) ms, and (28.3±3.3)%, respectively. The values of T₁, T₂, and ECV in females were higher than those in males: T₁ [(1 121±78) ms vs. (1 065±61) ms, P < 0.05], T₂ [(53.3±1.4) ms vs. (52.7±1.9) ms, P < 0.05], and ECV [(29.1±2.9)% vs. (27.7±3.5)%, P < 0.001]. The values of T₁ and ECV increased with age, but there was no statistical difference. The T₂ values of myocardium basal segment showed statistically significant differences between different age groups, and there was a correlation between T₁ and T₂ values and age in the whole population. The age correlation of T₂ values was shown only in the male population, and the age correlation of T₁ and ECV values was independent of gender. In the analysis of ethnic variability, ethnic minorities had significantly higher T₁ values than Han Chinese, but the between-group differences in T₂ and ECV values were not statistically significant. Conclusion In this study, the values of T₁, T₂, and ECV in the myocardium of health adult vary with age, gender, and ethnicity. It is necessary to correct the age, gender, and ethnicity when using quantitative techniques for CMR parameters to help clinicians diagnose cardiac disease more accurately and determine disease progress based on local reference values.
- Cardiovascular magnetic resonance /
- T₁ mapping /
- T₂ mapping /
- Extracellular volume fraction /
- Normal reference value

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图 1 1例健康受试者的心肌影像

注：A为左室短轴心内膜(红色)、心外膜(绿色)及血池(黄色)的勾画；B~E为依次为原始T₁、增强后T₁、原始T₂及ECV的伪彩图；F为左室长轴图像的最大左室范围图；G为原始T₁值的AHA16节段极坐标图。

Figure 1. Myocardial imaging of a healthy subject

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表 1 研究人群的一般基线资料及心功能参数比较

Table 1. Comparison of general baseline data and cardiac function parameters in the study population

项目	合计(n=122)	男性(n=68)	女性(n=54)	统计量	P值
年龄[M(P₂₅, P₇₅)，岁]	58.0(50.8, 64.0)	55.5(45.5, 62.0)	60.0(53.5, 70.0)	3.086^a	0.003
身高[M(P₂₅, P₇₅)，m]	1.7(1.6, 1.8)	1.70(1.70, 1.80)	1.62(1.60, 1.64)	-8.855^a	0.001
体重[M(P₂₅, P₇₅)，kg]	72.5(65.0, 77.8)	75.0(70.0, 85.0)	65.0(64.3, 70.5)	-5.639^a	0.001
BMI[M(P₂₅, P₇₅)]	25.4(23.9, 27.0)	25.4(24.2, 27.1)	25.6(23.6, 27.1)	-0.670^a	0.503
BSA[M(P₂₅, P₇₅)，m²]	1.8(1.7, 2.0)	1.9(1.8, 2.0)	1.7(1.7, 1.8)	-6.578^a	0.001
少数民族[例(%)]	27(22.13)	15(22.05)	12(22.22)	0.001^b	0.983
HR[M(P₂₅, P₇₅)，次/min]	66(61, 73)	66(60, 74)	66(61, 72)	-0.168^a	0.867
LVEDV/BSA[M(P₂₅, P₇₅)，mL/m²]	61.7(53.9, 69.5)	57.7(52.5, 67.1)	65.3(58.1, 73.7)	-1.365^a	0.175
LVESV/BSA[M(P₂₅, P₇₅)，mL/m²]	25.1(20.5, 31.0)	21.5(17.9, 27.8)	28.4(22.8, 33.1)	-1.046^a	0.298
LVEF[M(P₂₅, P₇₅)，%]	60.2(55.0, 64.3)	63.0(59.1, 66.9)	57.9(54.2, 62.7)	2.422^a	0.001
左室舒张期质量指数[M(P₂₅, P₇₅)，g/m²]	42.3(37.0, 48.5)	46.3(40.5, 51.5)	38.0(33.2, 42.6)	-5.247^a	0.001
左室收缩期质量指数[M(P₂₅, P₇₅)，g/m²]	47.7(40.8, 43.7)	50.6(46.3, 56.6)	41.6(37.0, 47.1)	-5.551^a	0.001
注：^a为Z值，^b为χ²值。BMI为体重指数；BSA为体表面积；HR为心率；LVEDV/BSA为左室舒张末期容积指数；LVESV/BSA为左室收缩期末容积指数；LVEF为左室射血分数。

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表 2 研究人群的CMR定量参数在性别间比较(x ± s)

Table 2. The quantitative parameters of CMR in the study population were compared between genders(x ± s)

项目	类别	总体人群	男性(n=68)	女性(n=54)	t值	P值
T₁(ms)	基底段	1 114±79	1 080±68	1 156±77	-5.933	0.001
	中间段	1 072±55	1 051±48	1 097±53	-4.520	0.001
	心尖段	1 084±80	1 063±65	1 111±88	-3.314	0.001
	整体	1 090±74	1 065±61	1 121±78	-7.643	0.001
T₂(ms)	基底段	52.5±1.9	52.2±2.2	52.9±1.4	-2.218	0.028
	中间段	52.5±1.6	52.3±1.8	52.9±1.2	-2.197	0.030
	心尖段	53.8±1.4	53.7±1.4	54.0±1.3	-0.974	0.332
	整体	53.0±1.7	52.7±1.9	53.3±1.4	-2.982	0.003
ECV(%)	基底段	27.8±2.5	27.2±2.0	28.6±3.0	0.989	0.005
	中间段	28.2±2.6	27.5±2.0	29.1±3.0	0.231	0.001
	心尖段	29.0±4.4	28.4±5.4	29.7±2.6	1.453	0.073
	整体	28.3±3.3	27.7±3.5	29.1±2.9	1.511	0.001

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表 3 研究人群的CMR定量参数在不同年龄组间比较

Table 3. The quantitative parameters of CMR in the study population were compared between different age groups

项目		≤55岁(n=49)	＞55岁(n=73)	统计量	P值
年龄[M(P₂₅, P₇₅)，岁]		48.0(38.5, 51.5)	62.0(59.0, 70.0)	-9.347^a	0.001
性别(男/女，例)		34/15	34/39	5.148^b	0.023
BMI[M(P₂₅, P₇₅)]		25.9(24.1，27.5)	25.4(23.7, 26.6)	-0.569^a	0.569
BSA[M(P₂₅, P₇₅)，m²]		1.88(1.77, 2.01)	1.79(1.71, 1.90)	-2.466^a	0.014
HR[M(P₂₅, P₇₅)，次/min]		68(62, 75)	65(60, 71)	-1.490^a	0.136
LVEDV/BSA[M(P₂₅, P₇₅)，mL/m²]		65.4(56.7, 74.1)	60.5(52.8, 67.6)	-2.243^a	0.025
LVESV/BSA[M(P₂₅, P₇₅)，mL/m²]		27.2(23.1, 31.9)	22.6(19.1, 29.7)	-2.462^a	0.014
LVEF[M(P₂₅, P₇₅)，%]		59.7(54.3, 64.0)	61.0(55.4, 65.5)	-1.199^a	0.231
左室舒张期质量指数[M(P₂₅, P₇₅)，g/m²]		45.8(38.7, 50.7)	40.3(36.1, 46.1)	-2.509^a	0.012
左室收缩期质量指数[M(P₂₅, P₇₅)，g/m²]		49.4(44.2, 55.3)	45.3(39.4, 51.7)	-2.259^a	0.024
T₁(x ± s，ms)	基底段	1 099±68	1 124±86	-2.259^a	0.024
	中间段	1 071±58	1 073±54	-0.462^a	0.644
	心尖段	1 071±76	1 093±81	-1.648^a	0.099
	整体	1 080±68	1 097±77	-2.038^a	0.042
T₂(x ± s，ms)	基底段	52.1±1.7	52.8±2.0	-2.645^a	0.008
	中间段	52.5±1.6	52.5±1.6	-0.574^a	0.566
	心尖段	53.9±1.0	53.8±1.6	-0.159^a	0.873
	整体	52.8±1.6	53.1±1.8	-1.492^a	0.136
ECV(x ± s，%)	基底段	28.0±2.7	27.7±2.4	-0.467^a	0.640
	中间段	28.2±2.7	28.2±2.7	-0.264^a	0.792
	心尖段	28.4±4.8	29.3±4.2	-1.078^a	0.281
	整体	28.2±3.4	28.4±3.3	-0.356^a	0.722
注：^a为Z值，^b为χ²值。

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表 4 研究人群的CMR定量参数在不同民族间比较

Table 4. The quantitative parameters of CMR in the study population were compared among different nationalities

项目		少数民族(n=27)	汉族(n=27)	统计量	P值
年龄[M(P₂₅, P₇₅), 岁]		51.0(37.0, 60.0)	51.0(43.0, 60.0)	-0.312^a	0.755
性别(男/女，例)		15/12	16/11	0.076^b	0.783
BMI[M(P₂₅, P₇₅)]		26.0(24.5，28.3)	26.0(24.7, 27.2)	-0.502^a	0.616
BSA[M(P₂₅, P₇₅)，m²]		1.9(1.8, 2.2)	1.9(1.8, 2.0)	-0.762^a	0.446
HR[M(P₂₅, P₇₅)，次/min]		69(59, 77)	68(61, 71)	-0.286^a	0.775
LVEDV/BSA[M(P₂₅, P₇₅)，mL/m²]		67.1(57.9, 79.5)	65.4(58.5, 73.1)	-0.562^a	0.574
LVESV/BSA[M(P₂₅, P₇₅)，mL/m²]		29.6(23.7, 33.2)	25.4(21.5, 31.0)	-1.047^a	0.295
LVEF[M(P₂₅, P₇₅), %]		60.1(55.0, 63.9)	60.6(54.6, 67.4)	-1.055^a	0.291
左室舒张期质量指数[M(P₂₅, P₇₅), g/m²]		43.2(38.4, 49.3)	45.9(37.0, 52.4)	-0.268^a	0.789
左室收缩期质量指数[M(P₂₅, P₇₅), g/m²]		49.4(43.6, 55.8)	46.6(42.1, 55.6)	-0.666^a	0.505
T₁(x ± s, ms)	基底段	1 113±49	1 112±104	-0.753^a	0.452
	中间段	1 092±50	1 060±55	-2.292^a	0.022
	心尖段	1 087±68	1 067±77	-1.064^a	0.287
	整体	1 098±57	1 081±84	-2.280^a	0.023
T₂(x ± s, ms)	基底段	52.3±1.9	52.6±1.7	-0.493^a	0.622
	中间段	52.6±1.4	52.5±1.8	-0.061^a	0.952
	心尖段	54.2±1.2	54.2±1.0	-0.026^a	0.979
	整体	53.0±1.7	53.1±1.7	-0.333^a	0.739
ECV(x ± s, %)	基底段	28.6±3.2	27.4±2.4	-1.306^a	0.192
	中间段	28.3±2.8	28.3±2.4	-0.182^a	0.856
	心尖段	28.9±3.7	28.3±5.1	-0.510^a	0.610
	整体	28.6±3.2	28.0±3.5	-1.092^a	0.275
注：^a为Z值，^b为χ²值。

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表 5 观察者间和观察者内一致性分析

Table 5. Inter-observer and intra-observer consistency analysis

参数	观察者间			观察者内
参数	ICC	95% CI	P值	ICC	95% CI	P值
T₁(ms)	0.892	0.869~0.911	＜0.001	0.905	0.885~0.922	＜0.001
T₂(ms)	0.953	0.942~0.961	＜0.001	0.941	0.921~0.952	＜0.001
ECV(%)	0.920	0.903~0.934	＜0.001	0.903	0.882~0.920	＜0.001

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参考文献(24)

[1]	ISMAIL T F, STRUGNELL W, COLETTI C, et al. Cardiac MR: from theory to practice[J]. Front Cardiovasc Med, 2022, 9: 826283. DOI: 10.3389/fcvm.2022.826283.
[2]	洪雪冬, 郑穗生, 许玲, 等. 心脏磁共振对原发扩张性心肌病左心整体功能和心肌纤维化的应用研究[J]. 中华全科医学, 2019, 17(4): 633-636, 665. doi: 10.16766/j.cnki.issn.1674-4152.000754 HONG X D, ZHENG H S, XU L et al. Study of left ventricular global function and myocardial fibrosis in patients with primary dilated cardiomyopathy by cardiac magnetic resonance imaging[J]. Chinese Journal of General Practice, 2019, 17(4): 633-636, 665. doi: 10.16766/j.cnki.issn.1674-4152.000754
[3]	NAKOU E, PATEL R K, FONTANA M, et al. Cardiovascular magnetic resonance parametric mapping techniques: clinical applications and limitations[J]. Curr Cardiol Rep, 2021, 23(12): 185. doi: 10.1007/s11886-021-01607-y
[4]	HAN Y, CHEN Y, FERRARI V A. Contemporary application of cardiovascular magnetic resonance imaging[J]. Annu Rev Med, 2020, 71: 221-234. doi: 10.1146/annurev-med-041818-015923
[5]	CAREDDA G, BASSAREO P P, CAU R, et al. Emerging role of cardiac magnetic resonance imaging in diagnosing myocarditis: a blunder or the way to get the problem sorted?[J]. J Thorac Imaging, 2022, 37(2): W12-W27. doi: 10.1097/RTI.0000000000000634
[6]	FERREIRA V M, PIWCHNIK S K. CMR parametric mapping as a tool for myocardial tissue characterization[J]. Korean Circ J, 2020, 50(8): 658-676. doi: 10.4070/kcj.2020.0157
[7]	陈秀玉, 赵世华. 2017 SCMR心脏磁共振参数定量技术专家共识解读[J]. 磁共振成像, 2018, 9(5): 368-373. https://www.cnki.com.cn/Article/CJFDTOTAL-CGZC201805009.htm CHEN Y X, ZHAO S H. The interpretation of a consensus statement for parametric mapping techniques with cardiovascular magnetic resonance by SCMR in 2017[J]. Chin J Magn Reson Imaging, 2018, 9(5): 368-373. https://www.cnki.com.cn/Article/CJFDTOTAL-CGZC201805009.htm
[8]	GASTL M, SOKKLSKA J M, POLACIN M, et al. Parametric mapping CMR for the measurement of inflammatory reactions of the pericardium[J]. Open Heart, 2022, 9(1): e001919. DOI: 10.1136/openhrt-2021-001919.
[9]	LEINER T, BOGAERT J, FRIEDRICH M G, et al. SCMR position paper (2020) on clinical indications for cardiovascular magnetic resonance[J]. J Cardiovasc Magn Reson, 2020, 22(1): 76. doi: 10.1186/s12968-020-00682-4
[10]	KALAPOS A, SZABO L, DOHY Z, et al. Automated T₁ and T₂ mapping segmentation on cardiovascular magnetic resonance imaging using deep learning[J]. Front Cardiovasc Med, 2023, 10: 1147581. DOI: 10.3389/fcvm.2023.1147581.
[11]	黄淑梅, 江桂华, 汪天悦, 等. 心脏磁共振细胞外容积在高血压性心脏病中的应用[J]. 磁共振成像, 2021, 12(3): 98-101. https://www.cnki.com.cn/Article/CJFDTOTAL-CGZC202103025.htm HUANG S M, JIANG G H, WANG T Y, et al. Application of cardiac magnetic resonance extracellular volume in hypertensive heart disease[J]. Chin J Magn Reson Imaging, 2021, 12(3): 98-101. https://www.cnki.com.cn/Article/CJFDTOTAL-CGZC202103025.htm
[12]	JANG J, NGO L H, CAPTUR G, et al. Measurement reproducibility of slice-interleaved T₁ and T₂ mapping sequences over 20 months: a single center study[J]. PLoS One, 2019, 14(7): e220190. DOI: 10.1371/journal.pone.0220190.
[13]	GRANITZ M, MOTLOCH L J, GRANITZ C, et al. Comparison of native myocardial T₁ and T₂ mapping at 1.5T and 3T in healthy volunteers: reference values and clinical implications[J]. Wien Klin Wochenschr, 2019, 131(7-8): 143-155. doi: 10.1007/s00508-018-1411-3
[14]	DENG W, XUE Y, LI Y, et al. Normal values of aagnetic resonance T(1rho) relaxation times in the adult heart at 1.5T MRI[J]. J Magn Reson Imaging, 2023, 58(2): 477-485. doi: 10.1002/jmri.28506
[15]	GROSCHEL J, TRAUZEDDEL R F, MULLER M, et al. Multi-site comparison of parametric T₁ and T₂ mapping: healthy travelling volunteers in the Berlin research network for cardiovascular magnetic resonance (BER-CMR)[J]. J Cardiovasc Magn Reson, 2023, 25(1): 47. doi: 10.1186/s12968-023-00954-9
[16]	HENNINGSSON M. Cartesian dictionary-based native T(1) and T(2) mapping of the myocardium[J]. Magn Reson Med, 2022, 87(5): 2347-2362. doi: 10.1002/mrm.29143
[17]	BAESSLER B, SCHAARSCHMIDT F, STEHNING C, et al. A systematic evaluation of three different cardiac T₂-mapping sequences at 1.5 and 3T in healthy volunteers[J]. Eur J Radiol, 2015, 84(11): 2161-2170. doi: 10.1016/j.ejrad.2015.08.002
[18]	HUANG Q, MENDES J, ADLURU G, et al. Technical note: accuracy and precision of T₂ and T₂* with a gradient-echo spin-echo (GESE) sequence for cardiac imaging[J]. Med Phys, 2023, 50(12): 7946-7954. doi: 10.1002/mp.16569
[19]	NAKAMORI S, DOHI K. Myocardial tissue imaging with cardiovascular magnetic resonance[J]. J Cardiol, 2022, 80(5): 377-385. doi: 10.1016/j.jjcc.2022.02.006
[20]	MELONI A, NICOLA M, POSITANO V, et al. Myocardial T₂ values at 1.5T by a segmental approach with healthy aging and gender[J]. Eur Radiol, 2022, 32(5): 2962-2975. doi: 10.1007/s00330-021-08396-6
[21]	ALSAIED T, TSENG S Y, SIDDIQUI S, et al. Pediatric myocardial T₁ and T₂ value associations with age and heart rate at 1.5T[J]. Pediatr Cardiol, 2021, 42(2): 269-277. doi: 10.1007/s00246-020-02479-9
[22]	XU Z, LI W, WANG J, et al. Reference ranges of myocardial T₁ and T₂ mapping in healthy Chinese adults: a multicenter 3T cardiovascular magnetic resonance study[J]. J Cardiovasc Magn Reson, 2023, 25(1): 64. doi: 10.1186/s12968-023-00974-5
[23]	YAMAGATA K, YAMAGATA L M, ABELA M, et al. Native T₁ and T₂ reference values for maltese healthy cohort[J]. Int J Cardiovasc Imaging, 2023, 39(1): 153-159.
[24]	JARKMAN C, CARLHALL C J, HENNINGSSON M. Clinical evaluation of the multimapping technique for simultaneous myocardial T(1) and T(2) mapping[J]. Front Cardiovasc Med, 2022, 9: 960403. DOI: 10.3389/fcvm.2022.960403.