扩张型心肌病患者左心室肌小梁磁共振成像分析  

Comparison of left ventricular trabeculation MRI between dilated cardiomyopathy and normal volunteer

作　　者：方芳[1] 程流泉[2] 单兆亮[1] 

机构地区：[1]解放军总医院心内科,北京100853 [2]解放军总医院海南分院核磁室

出　　处：《中华临床医师杂志（电子版）》2012年第19期5881-5886,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(30970772)

摘　　要：目的分析扩张型心肌病(DCM)患者左心室肌小梁增多的磁共振成像(MRI)特征,探讨左心室肌小梁与DCM的关系。方法利用心脏MRI检查,测量50例DCM患者以及45例正常志愿者左心室非致密心肌(NC)、致密心肌(C)以及室间隔基底部(IVS)厚度,计算NC/C值及C/IVS值。将左心室划分为17节段,对两组有肌小梁的节段进行计数。结果 DCM组NC/C值为1.52±0.56,志愿者组为0.98±0.38,DCM患者NC/C值较正常志愿者组大,其左心室肌小梁厚度比正常志愿者高,两组NC/C值与C/IVS值均呈负相关。DCM受累节段数(3.98±2.18)多于正常志愿者受累节段数(3.16±1.58)。DCM心尖(17节段)受累共8例占16%,志愿者第17节段受累共5例占11%,两者无统计学差异。DCM和正常志愿者NC分布节段相似,分布较多的节段为前壁、下壁及侧壁心尖段(第13、15、16节段),侧壁及前壁中间段(第11、12、7节段),心尖(第17节段)较少分布。两组在室间隔基底段(第2、3节段)、室间隔中间段(第8节段)、心尖隔段(第14节段)未见NC分布。结论 DCM左心室壁有过度小梁化倾向,可能其左心室肌小梁增多是一种较普遍的现象,DCM受累节段的分布与正常志愿者相似。Objective To investigate the cardiac MRI features of dilated cardiomyopathy(DCM)with left ventricular myocardial trabeculation and analyze the relationship between left ventricular trabeculation and DCM.Methods The magnetic resonance images were analyzed,left ventricular noncompaction(NC)and the compact myocardium thickness(C)in 50 patients with DCM and 45 normal volunteers were measured,the NC/C ratio were calculated.The number and the degree of hypertrabeculation were evaluated using the 17-segment model.Results The NC/C was significantly greater in patients with DCM(NC/C=1.52±0.56)than in the normal volunteers(NC/C=0.98±0.38).The wall thinkness of noncompaction was significantly higher in patients with DCM than that in normal volunteers.There were negative correlations between NC/C and C/IVS at two groups.The number of hypertrabeculation segment in DCM patients(3.98±2.18)was significantly higher than the number of NC segments in normal volunteer(3.16±1.58).The cases of left ventricular apex(the 17th segment)with hypertrabeculation in DCM were eight(16%)and in volunteers were five(11%),but no statistical significance were detected.The distribution of hypertrabeculation in DCM and normal volunteer was similar.There were more common in the apical segment of anterior,inferior and lateral(13th,15th and 16th segments)and in the mid segment of lateral and anterior(11th,12th and 7th segments).There were less in the left ventricular and no NC distribution in basal,mid and apical septal segments(2th,3th,8th and 14th segments).Conclusions The hypertrabeculation in left ventricular of DCM may be a more common phenomenon.The segments of trabeculation in DCM and normal volunteer were similar.

关 键 词：心肌病 扩张型 磁共振成像 左心室肌小梁 

分 类 号：R542.2[医药卫生—心血管疾病]