摘要
目的探讨 MRI 在儿童心肌病诊断中的价值。方法搜集心肌病患儿33例,其中肥厚型心肌病13例,扩张型心肌病10例,限制型心肌病7例,致心律不齐性右心室发育不良型心肌病3例。MR 采用不同序列不屏气扫描,13例肥厚型心肌病中9例选取左心室8个节段进行室壁厚度测量及心肌增厚率计算,并测定左心室收缩功能。对10例扩张型心肌病中7例测定左心室收缩功能。上述2组左心室收缩功能结果与心脏超声(ECHO)结果比较。7例限制型心肌病对其右心室流人道、流出道、心尖、右心房及下腔静脉的 MRI 表现与心血管造影进行比较。对3例致心律不齐性右心室发育不良型心肌病结合解剖特点、临床特点综合评估,并测量左右心室收缩功能。结果 13例肥厚型心肌病中9例 MRI 显示基底部游离壁前外侧段心肌增厚率(16%)及心尖部前段心肌增厚率(16%)下降明显,左心室收缩功能略下降,射血分数为57%,心肌质量有所增高(114 g/m^2),与ECHO 相比,左心室舒张末容量及每搏量上差异有统计学意义(P 值分别为0.0255和0.0341)。10例扩张型心肌病中7例左心室收缩功能下降,射血分数为20.7%,与 ECHO 比较在每搏量测定上差异有统计学意义(P=0.0106)。7例限制型心肌病 MRI 显示右心房明显扩大,上下腔静脉、肝静脉扩张,右心室腔变形,流人道缩短,心尖闭塞,流出道扩张。3例致心律不齐性右心室发育不良型心肌病中显示右心室球形扩张,右心室室壁局部变薄,1例见脂肪浸润,3例左右心室收缩功能均下降。结论 MPI 是目前诊断儿童心肌病中较好的非创伤性检查方法,其高分辨率可提供儿童心肌病解剖上的信息并能较 ECHO 提供更为准确的左右心室功能评估。
Objective To evaluate MR/ in the diagnosis of cardiomyopathy in Children. Methods Thirty-three cases of cardiomyopathy of children were examined, including 13 cases of hypertrophic cardiomyopathy, 10 cases of dilated cardiomyopathy, 7 cases of restrictive cardiomyopathy and 3 cases of arrhythmogenic right ventricular dysplasia. Different sequences were performed without breath holding. In 9 of 13 cases of hypertrophic cardiomyopathy, measurement of thickening wall in 8 segments were performed and systolic function was calculated. In 7 of 10 cases of dilated cardiomyopathy, systolic function was evaluated. MR/ results of the two groups were compared with those of echocardiography. In 7 cases of restrictive cardiomyopathy, comparison of findings between MR/ and cardioangiography was performed. In 3 cases of arrhythmogenic right ventricular dysplasia, evaluation of MR/ findings and clinical features was performed. The systolic function of right ventricle and left ventricle were evaluated. Results In 9 cases of hypertrophic cardiomyopathy, the systolic thickening ratio decreased obviously in basal anteriolateral（ 16% ） segment and apical anterior（ 16% ）segment. Systolic function decreased mildly （EF 57% ）. Masses of left ventricle increased（ 114 g/m^2）. Significant difference between MR/ and echocardiography was detected in end diastolic volume and stroke volume （ P = 0. 0255, 0. 0341 ）. In 7 cases of dilated cardiomyopathy, systolic function decreased obviously （EF 20.7%）. Significant difference between MRI and echocardiography was seen in stroke volume （P =0. 0106）. In 7 cases of restrictive cardiomyopathy, MRI showed dilated right atrium, inferior vena cava and hepatic vein. Configuration of right ventricle has changed, including shortening inflow tract and dilated outflow track. In 3 cases of arrhythmogenic right ventricular dysplasia, MR/demonstrated global dilated right ventricle and regional thinning wall of the right ventricle. In one of 3 cases, fat infiltration appeared on T1 W i
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第8期787-791,共5页
Chinese Journal of Radiology
关键词
心肌疾病
磁共振成像
心血管造影术
超声心动描记术
Myocardial dieases
Magnetic resonance imaging
Angiocardiography
Echocardiography
