1.5T MRI分析扩张型心肌病左心室结构及心功能的诊断价值  

Diagnostic value of 1.5T MRI for analyzing left ventricular structure and cardiac function in dilated cardiomyopathy

作　　者：陈炜旎[1] 张建英[1] 印隆林[1] 吴筱芸[1] 

机构地区：[1]四川省人民医院/电子科技大学附属医院放射科,成都610072

出　　处：《重庆医学》2018年第4期460-462,466,共4页Chongqing medicine

基　　金：四川省卫生和计划生育委员会科研课题(17PJ495)

摘　　要：目的探讨1.5T磁共振成像(MRI)对原发性扩张型心肌病(IDCM)患者左心室结构及心功能的诊断价值。方法选择该院2016年1-12月诊治的IDCM患者67例(IDCM组),选择同时期45例健康志愿者为对照组,分析两组对象左心室结构参数[舒张末期内径(EDD)与收缩末期内径(ESD)、致密化厚度(C)、肌小梁厚度(NC)、室间隔基底段厚度(IVS)、短轴缩短率(ΔD)、室壁增厚率(ΔT)]及心功能状态[左心室舒张末期血容量(EDV)与收缩末期血容量(ESV)、射血分数(EF)、每搏输出量(SV)、心输出量(CO)]。结果 IDCM组患者的NC、NC/C、IVS、EDD、ESD、左心室舒张末期室壁厚度(TDD)、ESV及EDV均大于对照组,而C、C/IVS、ΔD、ΔT、心肌质量(MM)、左心室收缩末期室壁厚度(TSD)、CO、EF及SV均小于对照组,除C、IVS参数外,组间比较差异有统计学意义(P<0.05)。IDCM组患者中,与Ⅰ~Ⅱ级比较,Ⅲ、Ⅳ级患者ESV、EDV增加,SV、CO及EF减少,均差异有统计学意义(P<0.05);随着级数增加ESV及EDV值增加,SV、CO及EF减小,Ⅲ、Ⅳ级比较,差异有统计学意义(P<0.05)。结论 MRI可早期分析IDCM患者左心室结构参数与心功能状态,可有效定性地预判心功能情况。Objective To investigate the diagnostic value of 1.5 T magnetic resonance imaging（MRI）in the left ventricular structure and cardiac function of the patients with primary dilated cardiomyopathy（IDCM）.Methods Sixty-seven patients with IDCM（IDCM group）in this hospital from January to December 2016 were selected and contemporaneous 45 healthy volunteers served as the control group.The left ventricular structure parameters[end diastolic diameter（EDD）,end systolic diameter（ESD）,densifying thickness（C）,trabecular thickness（NC）,interventricular septal basement thickness（IVS）,short axis shortening rate（ΔD）,wall thickening rate（ΔT）],and cardiac function status[left ventricular end diastolic blood volume（EDV）,end-systolic blood volume（ESV）,ejection fraction（EF）,stroke volume（SV）and cardiac output（CO）]were analyzed in the two groups.Results The levels of NC,NC/C,IVS,EDD,ESD,TDD,ESV and EDV in the IDCM group were higher than those in the control group,while C,C/IVS,ΔD,ΔT,MM,TSD,CO,EF and SV were smaller than those in the control group,except for C and IVS,the difference in the intergroup comparison was statistically significant（P〈0.05）.In the IDCM group,compared with the grade Ⅰ-Ⅱ,ESV and EDV in the gradeⅢ and Ⅳ were cncreased,while SV,CO and EF decreased,the difference statistically significant（P〈0.05）.With the grade increase and ESV and EDV values were increased,SV,CO and EF were decreased,the difference had statistical significance（P〈0.05）.Conclusion MRI can early analyze the left ventricular structure parameters and cardiac function status in the patients with IDCM,and can pre-judge the heart function situation effectively and qualitatively.

关 键 词：心肌病 扩张型 左心室结构 心室功能 左 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]