原发性扩张型心肌病与孤立性左心室心肌致密化不全的MRI特征  

MRI characteristics of primary dilated cardiomyopathy and isolated left ventricular non-compaction

作　　者：陈晓荣[1] 舒锦尔[1] 潘勇浩[1] 胡红杰[2] 

机构地区：[1]金华市中心医院医学影像科,浙江金华321000 [2]浙江大学医学院附属邵逸夫医院放射科,浙江杭州310016

出　　处：《中国医学影像技术》2017年第8期1139-1142,共4页Chinese Journal of Medical Imaging Technology

基　　金：浙江省医药卫生科技省部共建项目(201463675);金华市科学技术局社会发展类重点项目(2014-3-009)

摘　　要：目的对比分析原发性扩张型心肌病与孤立性左心室心肌致密化不全的MRI特征。方法对18例原发性扩张型心肌病和10例孤立性左心室致密化不全患者行心脏MRI扫描。对比两者舒张末期最大病变节段非致密心肌厚度(NC)、相应节段舒张末期致密心肌厚度(C)、运动特点、病变节段数、最大病变节段短轴缩短率、病变节段的分布特点。结果 18例原发性扩张型心肌病患者共823个节段,出现非致密心肌的病变节段数为124个;孤立性左心室心肌致密化不全患者共397个节段,其中病变节段数有115个。孤立性左心室心肌致密化不全病变节段的NC、NC/C、NC/(NC+C)均高于原发性扩张型心肌病(P均<0.05),其病变节段的短轴缩短率也更高(P<0.05)。2组的病变节段均以心尖段心肌病变为主,基底段少有受累或不受累,游离壁中以前壁、侧壁受累居多,室间隔受累较少。结论原发性扩张型心肌病与孤立性左心室心肌致密化不全MRI各具特征,尤其是非致密心肌的分布特点、受累节段数、厚度、NC/C,对临床诊断和鉴别诊断具有重要作用。Objective To explore the MRI characterisitics of primary dilated cardiomyopathy and isolated left ventricular non-compaction.Methods The patients who were diagnosed as primary dilated cardiomyopathy（n=18）and isolated left ventricular non-compaction（n=10）were enrolled,and the MRI was performed.The thickness of non-compaction myocardium（NC）,compaction myocardium（C）in end-diastole,the feature of movement of myocardium,the number of non-compaction segment,the fraction shortening of non-compaction and the distribution were compared.Results Totally 823 segments were analyzed in primary dilated cardiomyopathy,in which 124 segments were non-compaction myocardium;397 segments were analyzed in isolated left ventricular non-compaction,in which 115 segments were non-compaction myocardium.The NC,NC/C,NC/（NC＋C）,and the fraction shortening of the isolated left ventricular non-compaction patients were higher than those of primary dilated cardiomyopathy patients（all P〈0.05）.The features of distribution showed that the apical segment was mostly involved,and the basal segment was less involved or hardly involved.The anterior and lateral segments were more involved in the free wall,the septal was less involved.Conclusion The MRI characteristics of primary dilated cardiomyopathy and isolated left ventricular non-compaction are different,especially in the distribution,noncompacted segments,NC and NC/C,which is important for diagnosis and differential diagnosis of the two diseases.

关 键 词：心肌病 扩张型 心肌致密化不全 磁共振成像 

分 类 号：R541[医药卫生—心血管疾病] R445.2[医药卫生—内科学]