扩张型心肌病左室肌小梁MRI测量及与左室功能的相关性  

Relation between left ventricular trabecula measurement parameters and left ventricular function in patients with dilated cardiomyopathy

作　　者：方芳[1,2] 程流泉[1] 单兆亮[1] 王利东[3] 

机构地区：[1]解放军总医院心内科,北京100853 [2]解放军第273医院心内科,新疆库尔勒841000 [3]内蒙古医科大学附属人民医院影像科,内蒙古呼和浩特010050

出　　处：《解放军医学院学报》2013年第3期204-207,共4页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金项目(30970772)~~

摘　　要：目的初步探讨扩张型心肌病(dilated cardiomyopathy,DCM)患者左室肌小梁与心功能的关系。方法利用心脏MRI检查,测量30例DCM患者左室非致密心肌(noncompacted myocardium,NC)厚度、致密心肌(compacted myocardium,C)厚度、左室非致密心肌面积(NC area)、致密心肌面积(C area),计算NC/C比值及NC area/C area比值。超声测量左室收缩末期容积(left ventricular end-systolic volume,LVESV)、左室舒张末期容积(left ventricular end-diastolic volume,LVEDV)、左室射血分数(left ventricular ejection fraction,LVEF)。分析左室肌小梁MRI测量值与超声心功能相关参数的相关性。结果 DCM患者NC、NC/C比值与LVEF、LVEDV、LVESV无明显相关。DCM患者MRI左室非致密化心肌总面积NC area同LVEF呈负相关(r=-0.411,P=0.024),与LVEDV(r=0.551,P=0.002)、LVESV(r=0.586,P=0.001)呈正相关。DCM患者NC/C(1.56±0.63)与NC area/C area(0.51±0.17)呈正相关。NC/C>NC area/C area。DCM患者左室非致密化心肌总面积与非致密化心肌平均厚度呈正相关(r=0.624,P=0.000)。结论 DCM左室肌小梁增多可能与左室结构功能改变关联。面积法测量左室肌小梁可反映整个左室肌小梁增多情况,对定量分析左室肌小梁增多更具临床价值。Objective To study the relation between left ventricular trabecula measurement parameters and left ventricular function in patients with dilated cardiomyopathy （DCM）. Methods Non-compacted left ventricular thickness, compacted myocardium thickness, non-compacted and compacted myocardium area were measured in 30 DCM patients. Their ratios were calculated. Their LVESV, LVEDV and LVEF were measured by echocardiography. Relation between left ventricular trabecula measurement parameters and left ventricular function was analyzed. Results The non-compacted left ventricular thickness/compacted myocardium thickness ratio was not significantly related with the LVEF, LVEDV and LVESV in DCM patients. The total non-compacted and compacted myocardium area was negatively related with the LVEF （r=-0.411, P=0.024） and positively related with the LVEDV （r=- 0.551, P=0.002） and LVESV （r=0.586, P=0.001）. The non-compacted left ventricular thickness/compacted myocardium thickness ratio （1.56 ＋ 0.63） was positively related with the non-compacted myocardium thickness （0.51 _＋ 0.17） and was greater than the non- compacted/compacted myocardium area. The total non-compacted myocardium area was positively related with the total non- compacted myocardium thickness （r=0.624, P--0.000）. Conclusion The enlarged left ventricular trabecula may be related with the left ventricular structure and function in DCM patients. Measurement of the left ventricular trabecular area can show its enlargement and can thus contribute to the quantitative analysis of its enlargement.

关 键 词：心肌病 扩张型 磁共振成像 左心室肌小梁 左室心功能 

分 类 号：R445.2[医药卫生—影像医学与核医学]