摘要
目的探讨致心律失常性右室心肌病／发育不良（ARVC／D，arrythmogenic right ventricular cardiomyopathy／dysplasia）多参数MRI影像特征及诊断价值。方法收集我院2007年1月至2015年5月间5例ARVC／D的MRI资料，5例患者均符合2010年修订的ARVC诊断标准，MRI检查包括心脏形态、电影及延迟心肌活性成像。结果形态及电影MRI示ARVC／D右室心腔明显扩张及右室流出道扩大，室壁运动减低，3例右室肌壁及外膜缘见不均匀高信号，脂肪抑制后呈低信号，提示心肌脂肪侵润，2例右室心肌未见确切脂肪侵润表现；5例左心室室壁运动及EF值未见正常；延迟MR心肌活性成像（Deiayed enhcaning MRI，DE—MRI）显示右室肌壁变薄、肌壁呈弥漫性高信号，提示心肌纤维化；4例左室肌壁DE-MRI心肌活性未见异常，1例左室侧壁小灶纤维瘢痕，但瘢痕位于肌壁间、且无冠脉供血区分布表现。结论心脏MR形态及电影图像上右室心腔明显扩张和流出道的扩大、室壁运动的减低对ARVC／D诊断有明确的价值，结合DEMRI有助于判断右室心肌纤维化及其程度，但MRI检测的脂肪侵润对ARVC／D诊断的敏感性不高。此外，DE—MRI同时可检测左室肌壁有无纤维瘢痕形成及其范围与部位，有助于ARVC／D预后的判断。
Objective To study the imaging features and diagnostic value of multi-parameter MRI in arrhythmogenic right ventricular cardiomyopathy/dysplasia （ARVC/D）. Methods The MRI data of 5 patients eonfimed by ARVC/D according to the diagnostic criteria for ARVC（2010） from January 2007 to May ,2015 were collected. All of patients were examed by cardiac MRI including morphology, cine and delayed enhancement imaging. Results The signifeantly dilated right ventricular chamber and the right ventrieular outflow tract were showed in all of patients. Heterogeneous high signal in right ventricular wall were found in 3 eases, and its becamed lower signal in fat-saturation sequence corresponding to fatty infiltration. There were no evendience of fatty infiltration in other 2 cases. The normal left ventricular wall motion and EF score were found in 5 cases. On delayed enhcancement MR, the right ventricular wall showed diffuse high signal corresponding to myocardial fibrosis, but the left ventricular wall showed normal myocardial viability except to two foci sear in 1 case. Conclusion The signifcantly dilated right ventricular chamber and the right ventricular outflow tract on cardiac MR including morphology and cine scanning has clearly value in diagnosis of ARVC/D, but fatty infiltration on MRI has lower sensitivity. The DE-MRI ean help detecting the right ventricular myocardial fibrosis and its degree, and show wether myocardial scar is exist in left ventricular myocardial wall. So the MRI have diagnostie and prognostic value in ARVC/D.
出处
《检验医学》
CAS
2016年第B09期33-35,共3页
Laboratory Medicine
基金
国家自然科学基金（81260213）
云南省科技厅-昆明医科大学联合专项基金（2012FB054）
云南省教育厅科学研究重点项目（20142057）
关键词
致心律失常性右室心肌病/发育不良
磁共振成像
arrhythmogenic right ventricular dysplasia/cardiomyopathy
magnetic resonance imaging
