心脏MRI对左心室扩大疾病的鉴别诊断价值  

The value of cardiac magnetic resonance in differential diagnosis of the patients with left ventricular dilated

作　　者：刘雨蒙[1] 汪灵杰[1] 陈蒙[1] 朱静芬[1] 朱默[1] 胡春洪[1] LIU Yumeng;WANG Lingjie;CHEN Meng;ZHU Jingfen;ZHU Mo;HU Chunhong(Department of Radiology,The First Affiliated Hospital of Suzhou University,Suzhou 215006,P.R.China)

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215006

出　　处：《医学影像学杂志》2021年第6期949-953,共5页Journal of Medical Imaging

摘　　要：目的探讨心脏MRI在引起左心室扩大疾病中的鉴别诊断价值。方法选取并分析35例左心室扩大患者的MRI表现,测量左心室舒张末期最大横径、左心室壁各节段舒张末期厚度,观察心肌延迟强化表现。结果8例扩张型心肌病(DCM)均表现为左心室壁普遍变薄,其中6例出现室间隔肌壁间线样强化;12例缺血性心脏病(IHD)表现为肇事血管供血区心肌变薄,且相应区域出现心内膜下及透壁性强化;7例病毒性心肌炎(VMC)患者,均出现侧壁心外膜侧强化,其中6例可见室间隔肌壁间线样强化;6例左心室心肌致密化不全(LVNC)中,2例表现为室间隔肌壁间线样强化,4例无延迟强化;酒精性心肌病(ACM)和围产期心肌病(PPCM)各1例,均表现为左心室壁普遍变薄,无延迟强化。结论心脏MRI能够为左心室扩大疾病提供结构及功能信息,钆对比剂增强能够为这些疾病的鉴别提供有效依据。Objective To explore the role of cardiac magnetic resonance(CMR)imaging in the differential diagnosis of the patients with left ventricular dilated.Methods We retrospectively analyzed the MRI manifestations of 35 patients with left ventricular dilated.The end-diastolic left ventricular transverse diameter and segmental end-diastolic ventricular wall thickness were quantitatively measured.The position,extent and range of delayed enhancement in left ventricle were observed in all patients.Results In 8 patients with dilated cardiomyopathy(DCM),all exhibited the diffuse thinning of left ventricular,6 patients presented with the linear delayed enhancement at interventricular mid-wall.In 12 patients with ischemic heart disease(IHD),the myocardial thinning area was consistent with the blood supply area of narrow coronary arteries,and these areas presented the delayed enhancement at subendocardial wall or through the wall.In 7 patients with viral myocarditis(VMC),all appeared the delayed enhancement at epicardial wall,and 6 patients also appeared linear delayed enhancement at interventricular mid-wall.In 6 patients with left ventricular noncompaction(LVNC),2 presented with the linear delayed enhancement at interventricular mid-wall,and 4 had no delayed enhancement.One patient with alcoholic cardiomypathy(ACM)and one patient with peripartum cardiomypathy(PPCM)both exhibited the diffuse thinning of left ventricular,and had no delayed enhancement.Conclusion CMR may provide valuable diagnostic imaging for the patients with left ventricular dilated and late gadolinium enhancement could further differentiate the diagnosis.

关 键 词：左心室扩大 磁共振成像 钆对比剂延迟强化 

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