心脏磁共振成像(CMR)评价儿童心肌炎心肌损伤的临床研究  

Clinical Research of the Cardiovascular Magnetic Resonance Approach in Assessing Myocardial Injuries of Children with Myocarditis

作　　者：李佳[1,2] 刘桂英[1,2] 

机构地区：[1]首都医科大学附属北京安贞医院儿科 [2]北京市心肺血管疾病研究所,100029

出　　处：《中国病案》2013年第4期55-57,共3页Chinese Medical Record

基　　金：北京市科技计划项目;课题编号Z111100067311030

摘　　要：目的通过对心肌炎患儿心脏磁共振成像(CMR)检查,探讨CMR评价心肌炎患儿心肌损伤的可行性及临床价值。方法对首都医科大学附属北京安贞医院儿科20例心肌炎患儿行CMR检查,评价心脏功能、心肌组织病理改变性质、部位;分析心脏CMR心肌组织病理改变与20例患儿心电图(ECG)、心肌酶、X线、超声心动图(ECHO)结果的相关性。结果 20例心肌酶、ECG均有不同程度改变、ECHO及胸片显示心脏增大的心肌炎患儿,CMR检查结果提示左心室增大与ECHO一致;心肌损害检测敏感率100%;19例患儿CMRT2加权相时可见心肌组织水肿;1例肌钙蛋白正常,但是CMRT1延迟强化可见心外膜下小片状心肌坏死。结论相比临床诊断指标,CMR能够准确、无创的提供心肌炎患儿心肌损伤性质、程度,有助于临床诊断和判断预后;CMR显示儿童心肌炎心肌损伤部位以心外膜下为最常见。Objectives To discuss the viability and clinical value of Cardiovascular Magnetic Resonanee（CMR） approach in assess- ing myocardial injuries of children with myocarditis. Methods Conduct CMR test on twenty children with myocarditis in department of pediatrics in Beijing Anzhen Hospital. Evaluate the cardiac function, the nature and location of the myocardial pathology changes, and analyze the correlation among CMR pathological changes, electrocardiogram （ECG）, myocardial enzymes, X - ray and echocar- diography （ECHO）. Results The cardiac enzymes and ECG of the twenty children showed varying changes; ECHO and chest X - ray resuh showed cardiac enlargement. CMR showed left ventricular end-diastollc diameter increase was consistent.with ECHO. The sen- sitivity rate of detecting myocarditis injury is 100%. Nineteen cases of CMR tests showed myocardial edema in T2 - weighted. A pa- tient＇ s troponin was normal, but CMR showed small pieces subepicardial necrosis. Conclusions Compared with the clinical diagnostic indicators, CMR can accurately and non-invasively display the nature and extent in children with myocarditis which makes contribu- tion to the clinical diagnosis and prognosis. CMR shows that subepicardial edema is the most common in children with myocarditis.

关 键 词：儿童心肌炎 CMR 心肌损伤 临床研究 

分 类 号：R725.4[医药卫生—儿科]