磁共振在诊断心室肌致密化不全中的应用与价值  

The Application and Value of MRI in Diagnosis of Noncompaction of Ventricular Myocardium

作　　者：徐辉[1] 王宇[1] 

机构地区：[1]青海省人民医院放射科,810007

出　　处：《临床放射学杂志》2017年第3期356-359,共4页Journal of Clinical Radiology

摘　　要：目的探讨心室肌致密化不全的MRI表现特征,提高该病的诊断率并确立磁共振在诊断心室肌致密化不全中的应用价值。方法回顾性分析临床证实并磁共振诊断的6例心室肌致密化不全病例,利用MRI的心脏标准短轴位、两腔心、四腔心体位,完成心脏形态、功能、灌注及心肌活性检查,综合观察心肌结构、形态及心室的收缩舒张功能。结果左室型4例,双室型1例,右室型1例,右室均累及心尖处,左室按17节段划分在左室舒张末期测量患处心肌致密化不全心肌厚度与致密化心肌厚度比率(NC/C),并纳入10名成人健康志愿者为对照组进行对比研究,6例患者电影序列均有不同程度的室壁运动减弱,5例患者心肌灌注异常,4例患者出现纤维化。同时对比6例患者的心脏超声,磁共振右室检出心肌致密化不全2处,心脏超声未检出,左室心肌致密化不全磁共振检出率46%,心脏超声检出率为37%。结论心室肌致密化不全的MRI诊断具有特征性,各序列均有阳性表现,不仅能直接观察致密化不全的心肌,还可以观察心肌的灌注情况,更能反映出致密化不全心肌的活性,尤其在灌注和电影序列可以直接观察到粗大的肌小梁及深陷的小梁隐窝,能很好地观察右室及心尖处心肌,对受累节段、非致密化程度的分析明显优于心脏超声,与心脏超声筛查不同,心脏磁共振检查最终用于心肌致密化不全的确诊或排除诊断。Objective To investigate the MRI manifestations of noncompaction of ventricular myocardium, to improve the diagnostic rate of the disease and to establish the value of MRI in the diagnosis of noncompaction of ventficular myocardium. Methods 6 cases of clinically-confirmed ventricular myocardium noncompaction were retrospectively analyzed. Comprehensive observation was done to the myocardium structure and morphology as well as ventricular systolic and diastolic function, by using MRI cardiac standard short axis, two cavity, four cavity position and cardiac morphology, function, perfusion and myocardial activity was examined. Results The Left ventricle was involved in 4 cases, both ventricles in 1 case, and the right ventricle in 1 case. Lesions involved the right ventricular apex and Left ventricular myocardium by 17 section division. In left ventricular end-diastolic measuring myocardium densification, incomplete myocardial thickness and densification thickness ratio. 10 healthy adult volunteers were included in the control group. All the 6 cases had different degrees of ventricular wall motion hypokinesis in the eine sequence. 5 cases had abnormalities of myocardial perfusion. 4 cases had fibrosis. Simultaneous contrast of 6 cases with cardiac ultrasound and magnetic resonance imaging in investigating incomplete myocardial densification was done. Left ventricular incomplete myocardial densification on magnetic resonance had a detection rate of 46%. cardiac ultrasound detection rate was 37%. Conclusion MRI diagnosis of noncompaction of ventricular myocardium is characteristic and all sequences have positive presentation. It can directly observe not only the myocardium, but also the perfusion of myocardium, and can reflect the activity of the myocardium. With particular use of peffusion and movie sequences, it can observe the thick trabecular and the deep trabecular fossae, and can define the extent and degree of the lesion. Compared to ultrasound, it can give superior observation of the myocardium of the right ve

关 键 词：心肌致密化不全 磁共振成像 诊断 价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]