Magnetic Resonance Quantitative Analysis Of Viral Myocarditis And Its Application In TCM Syndromes

Objective:1.Cardiac magnetic resonance(CMR)can show the characteristic changes of myocardial tissue in acute myocarditis,and its clinical application has attracted more and more attention.In 2009,JACC put forward the "CMR Diagnostic Criteria Recommendation for Myocarditis" which is the Louis Lake Criteria,but it has certain subjectivity.Recent studies have shown that CMR quantitative tissue marker technique can quantitatively analyze the involved myocardium.Therefore,the purpose of this study is to explore the value of quantitative tissue marker technique in clinical diagnosis of viral myocarditis(VMC)and whether CMR can quantify the cardiac function and myocardial pathological changes of VMC in one-stop manner.2.To compare the difference of routine sequence of cardiac magnetic resonance(Louis Lake diagnosis)and quantitative evaluation value between VMC patients with heat toxin Chongxin syndrome and heat sadness Yin syndrome,in order to provide objective basis for TCM syndrome differentiation.Method:Nineteen patients(experimental group)with VMC diagnosed in Anzhen Hospital Affiliated to Capital Medical University from February 2018 to January 2019 were selected,including 11 patients with heat-toxin-heart-rushing syndrome and 8 patients with heat-sadness-yin syndrome,and 20 healthy volunteers(control group)were compared.Cardiac magnetic resonance(CMR)scans were performed on all subjects using a 3.0 T superconducting magnetic resonance machine(Verio,Siemens,Germany).Scanning sequence included:T2WI sequence,gadolinium contrast agent early enhancement(EGE)and delayed enhancement(LGE)sequence,T1-mapping and film sequence after initial and group GD-DTPA inj ection.The acquisition level includes two-chamber long axis,four-chamber long axis and left ventricular short axis.CMR images were obtained and analyzed.The main contents included:stroke output(SV),ventricular ejection fraction(EF),cardiac output(CO),initial T1 relaxation time of each segment,T1 relaxation time after GD-DTPA injection,and ECV by drawing T1 mapping color map.SPSS20.0 software was used for statistical analysis and Origin 2017 software was used for drawing.To evaluate the diagnostic value of CMR quantitative tissue marker in VMC,and to compare the differences between the parameters of heat toxin Chongxin syndrome and heat excessive injury Yin syndrome.Result:1.Compared with the control group,there were significant differences in SV,EF,CO,initial T1 relaxation time,T1 relaxation time and ECV value after GD-DTPA group injection(P<0.05).2.There were no significant differences in T2WI,EGE and LGE between VMC patients with heat toxin Chongxin syndrome and those with heat sadness Yin syndrome(P>0.05).3.There were no significant differences in cardiac function SV,EF,CO,initial T1 relaxation time,T1 relaxation time after GD-DTPA injection,ECV value and quantified scores of traditional Chinese medicine(P>0.05)between heat toxicity Chongxin syndrome and heat sadness Yin syndrome in VMC.Conclusion:1.As a non-invasive and non-radiation examination,CMR can quantitatively evaluate VMC.CMR quantitative tissue marker technology can provide objective imaging basis and quantitative data for the diagnosis of VMC,and CMR can quantitatively evaluate the cardiac function and myocardial pathological changes of VMC in one-stop manner.2.There is no significant difference between the parameters of magnetic resonance examination of VMC heat toxin Chongxin syndrome and heat sadness Yin syndrome.Therefore,according to the results of this experiment,CMR can not provide objective signs for the differentiation of syndrome types of VMC p atients.