孤立性左室心肌致密化不全的MRI特征  

MRI features of isolated left ventricular noncompaction

作　　者：王振福[1] 王黎明[1] 赵世华[2] 于进超[1] 王姝慧[1] 陆敏杰[2] 张岩[2] 程怀兵[2] 

机构地区：[1]山东省威海市立医院MRI室,山东威海264200 [2]中国医学科学院阜外心血管病医院放射科,北京100037

出　　处：《医学影像学杂志》2010年第3期347-351,共5页Journal of Medical Imaging

摘　　要：目的:研究经临床综合诊断确诊为孤立性心肌致密化不全(IVNC)的患者,分析MRI特征。方法:利用心脏MRI对30例IVNC患者的左心房、室径线及左心功能进行分析,将左心室划分为17节段,对致密化不全的节段计数,测量左室各节段致密化心肌(C)和非致密化心肌(NC)的厚度,计算NC/C比值。并分析延迟增强扫描后左心室各节段心肌的强化特点。22名成人健康者纳入对照组进行对比研究。结果:心脏MRI显示IVNC患者左心房、室扩张,有球形化的趋势〔球形指数(SI)=0.74±0.11〕;左室射血分数(LVEF=32.8±13.6)下降;IVNC患者致密化不全的节段数为9±2。所有IVNC患者的心尖段(第17节段)均受累,其他最常见的受累节段为侧壁中段、心尖段(第16、12、11节段),而室间隔基底段、中段(第2、3、8、9节段)未见受累。IVNC患者最常发生致密化不全的节段其致密化心肌厚度变薄,而不发生及很少发生致密化不全的节段,其致密化心肌厚度与正常对照组对应节段室壁厚度无差别。IVNC患者NC/C比值为3.2±0.8。延迟增强扫描发现11例IVNC患者共68个节段室壁有延迟强化。结论:心脏MRI既能清楚显示左室各节段(尤其是心尖部)的非致密化心肌,又能准确测量NC/C比值,是诊断IVNC的理想检查方法。Objective： The study was designed to determine the value of cardiac MRI in the diagnosis of isolated ventricular noncompaction（IVNC）,which was confirmed by clinical diagnosis.Methods：We analyzed the cardiac morphology and function in 30 patients with IVNC and 22 normal subjects.Using the 17-segment model,the wall thinkness of noncompaction（NC） and compacted（C） myocardium in the left ventricle were measured in diastole.The numbers of NC segment and NC/C ratio were evaluated.And the delayed enhancement mode of left ventricular myocardium in all segments was analyzed.Results：The IVNC patients had left ventricular（LV） dilatation and remodelling（sphericity index,SI=0.74±0.11）.The LV ejection fraction（32.8±13.6） was impaired.The number of NC segment in IVNC was 9±2.The left ventricular apex（17th segment） was unexceptionally involved in all IVNC.The apical and mid segments of LV lateral wall（16th,12th and 11th segments） were commonly involved while no NC in basal and mid septal segments（2nd,3rd,8th and 9th segments）.The thickness of compacted myocardium of the segments was associated with NC appeared thin.The wall thickness of compacted myocardium in the segments with less or no NC was similar to the normal group.The end-diastolic NC/C ratio was,on average,3.2±0.8 in patients with IVNC.Conclusion：Cardiac MRI can not only reveal NC of all LV segments,especially in the LV apex,but also accurately calculate the NC/C ratio.MRI is considered as an ideal imaging modality for IVNC.

关 键 词：孤立性 左室致密化不全 磁共振成像 

分 类 号：R542.2[医药卫生—心血管疾病] R445.2[医药卫生—内科学]