磁共振在诊断心室肌致密化不全中的应用与价值

发布时间：2018-03-01 07:04

本文关键词： 心肌致密化不全磁共振成像诊断价值　出处：《临床放射学杂志》2017年03期 　论文类型：期刊论文

【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。
[Abstract]:Objective to investigate the MRI features of ventricular dyskinesia. To improve the diagnostic rate of the disease and to establish the value of MRI in the diagnosis of ventricular muscle compaction insufficiency. Methods six cases of ventricular compaction insufficiency confirmed clinically and diagnosed by MRI were analyzed retrospectively, and the cardiac standard short axis of MRI was used. The cardiac morphology, function, perfusion and myocardial activity were examined. The myocardial structure, morphology and systolic and diastolic function of the ventricle were observed. Results there were 4 cases of left ventricular type, 1 case of biventricular type, 1 case of right ventricular type, 1 case of left ventricular type, 1 case of right ventricular type, 4 cases of left ventricular type, 1 case of biventricular type, and 1 case of right ventricular type. The right ventricle involved the apex, The ratio of myocardial densification to densified myocardial thickness was measured at the end of left ventricular diastolic end by 17 segments of left ventricle, and 10 healthy adult volunteers were enrolled in the control group to study the movie sequence of 6 patients. Myocardial perfusion abnormalities were found in 4 patients with myocardial dysfunction in 5 patients, and compared with echocardiography in 6 patients. There were 2 cases of myocardial densification in the right ventricle, 2 cases in the right ventricle, 46 cases in the left ventricle, and 37% in the left ventricle. Conclusion the MRI diagnosis of ventricular dyskinesia is characteristic. Each sequence has positive expression, not only can directly observe the densification of the myocardium, but also can observe the myocardial perfusion, but also can reflect the densification of the myocardial activity. Especially in perfusion and film sequences, the thick muscle trabeculae and deep trabecular recesses can be observed directly, and the right ventricular and apical myocardium can be well observed. The degree of non-densification of the involved segments is obviously superior to that of echocardiography. Unlike echocardiography, cardiac magnetic resonance is ultimately used to diagnose or exclude myocardial compactness.
【作者单位】：青海省人民医院放射科;
【分类号】：R445.2;R542.2

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