孤立性心肌致密化不全的MRI诊断  

MRI in the diagnosis of isolated noncompaction of ventricular myocardium

作　　者：苗翠莲[1] 张兆琪[1] 郭曦[1] 王珏[1] 宴子旭[1] 赵轶柯[1] 

机构地区：[1]首都医科大学附属北京安贞医院影像科,100029

出　　处：《中华放射学杂志》2005年第6期588-592,共5页Chinese Journal of Radiology

摘　　要：目的探讨孤立性心肌致密化不全(INVM)的MRI表现及其对该病诊断的价值。方法12例INVM患者均经超声心动图诊断。采用MRI不同脉冲序列,分析INVM心室结构、运动功能及心肌灌注的MRI表现。结果(1)左心室单独受累9例,双室受累3例,未见右室单独受累者。左心室心尖段及前壁中间段为最常见受累部位(12例);(2)心肌增厚并能分层,非致密化心肌信号不均匀,由多发、粗大、交错排列的肌小梁及小梁隐窝组成,致密心肌变薄,信号均匀;(3)小梁隐窝内血栓2例;(4)心肌灌注成像首过期,6例14段(14/99段)可见灌注缺损;延迟期左心室心肌强化4例23段(23/99段),其中1例伴右室心尖心肌强化;(5)左心室普遍收缩功能不良4例,节段性功能不良5例。结论MRI能清晰显示INVM的形态学改变、心室节段性及整体运动功能异常、心肌血流灌注及纤维化的程度和范围,对INVM诊断及预后评估具有重要价值。Objective To describe the MRI manifestations of INVM and evaluate the usefulness of MRI in the diagnosis of INVM. Methods 12 patients with INVM, 9 males and 3 females, with mean age of 43.72±18.39 years, were examined with multiple slice HASTE and TrueFISP sequences on a 1.5 T MR system ,the MRI manifestations of ventricular morphology ,function and perfusion were analysed. 11 of the patients were examined with IR-TuroFlash sequence for MRI myocardial imaging perfusion imaging. Results Among these 12 patients left ventricle was involved in 9, and both left and right ventricle were involved in 3.The INVM mainly expressed as thickened myocardium consisting of two layers: epicardial compacted thin myocardial and noncompacted thickened subendocardial myocardium, and the later manifested as prominent and excessive trabaculations and deep recesses. Myocardial perfusion defects of 14 segments and late enhancement of 24 segments were detected . Four patients with myocardial late enhancement had global left ventricular dysfunction and five had segmental dysfunction. Conclusion MR imaging may clearly demonstrate the abnormalities of cardiac morphology, global and regional ventricular function as well as myocardial perfusion and fibrosis of INVM, and it is quite useful in the diagnosis and evaluation of prognosis of INVM.

关 键 词：孤立性心肌致密化不全 MRI诊断 超声心动图诊断 INVM MRI表现及 心肌灌注成像 收缩功能不良 运动功能异常 心肌血流灌注 形态学改变 左心室 脉冲序列 心室结构 心肌信号 灌注缺损 预后评估 节段性 小梁 纤维化 价值 单独 

分 类 号：R445.2[医药卫生—影像医学与核医学]