Weiss F, Habermann C R, Lilje C, Razek W, Sievers J, Weil J, Adam G
Radiologisches Zentrum, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg.
Rofo. 2003 Sep;175(9):1214-9. doi: 10.1055/s-2003-41932.
To report the detection of non-compacted ventricular myocardium (NCVM) with MRI compared to echocardiography in 8 patients.
Non-compaction of the ventricular myocardium is a congenital disorder characterized by an altered structure of the myocardial wall resulting from an intrauterine arrest in endomyocardial embryogenesis. The morphological findings consist of a prominent meshwork of multiple myocardial trabeculations and deep intertrabecular recesses, communicating with the left ventricular cavity. 8 consecutive patients (mean age 7.3 years) with clinical and echocardiographic signs of NCVM were examined by MRI (1.5 T, Vision, Siemens) in short axis and 2- and 4-chamber views, using T (1)-weighted TSE and Cine-GRE in 6 patients and true FISP sequences in 2 patients. MRI and echocardiography were evaluated for visibility, signs of NCVM and involvement of myocardial wall segments. Thickness was measured for non-compacted and compacted myocardium and the non-compacted to compacted (N/C) ratio calculated.
MRI diagnosed 6 of 8 patients of having NCVM. Myocardial thickness as measured by echocardiography and MRI showed a good correlation in compacted myocardium (r = 8.82) and no correlation in non-compacted myocardium (r = 0.4). In 2 cases, non-compacted myocardium was detected but echocardiography did not reach the N/C ratio > 2 as required to diagnose NCVM in accordance with the criteria found in the literature. Both patients were also misdiagnosed by MRI performed with Cine-GRE. MRI reached a N/C ratio > 2 in only three patients. Newer TruFisp sequences showed no definite advantages. Extent of non-compaction could be visualized correctly with MRI.
Echocardiography is the method of choice to detect NCVM. MRI can be an alternative in some cases. The diagnosis of NCVM should not be considered until N/C ratio is over 2.
报告8例患者经磁共振成像（MRI）与超声心动图检查发现的心肌致密化不全（NCVM）情况。
心肌致密化不全是一种先天性疾病，其特征是心肌壁结构改变，这是由于心内膜胚胎发育过程中子宫内发育停滞所致。形态学表现为多个心肌小梁形成的突出网状结构以及小梁间深凹陷，与左心室腔相通。对8例有NCVM临床及超声心动图表现的连续患者（平均年龄7.3岁）进行了MRI（1.5T，Vision，西门子）检查，扫描短轴以及两腔和四腔视图，6例患者使用T（1）加权快速自旋回波序列（TSE）和电影梯度回波序列（Cine-GRE），2例患者使用真稳态进动快速成像序列（true FISP）。对MRI和超声心动图检查结果评估其对NCVM的显示情况、心肌壁节段受累情况。测量致密化和非致密化心肌的厚度并计算非致密化与致密化（N/C）比值。
MRI诊断出8例患者中有6例患有NCVM。超声心动图和MRI测量的致密化心肌厚度显示出良好的相关性（r = 8.82），而非致密化心肌厚度无相关性（r = 0.4）。2例患者检测到非致密化心肌，但超声心动图未达到文献中诊断NCVM所需的N/C比值>2。这2例患者使用Cine-GRE序列进行的MRI检查也误诊。只有3例患者的MRI达到N/C比值>2。更新的TruFisp序列未显示出明显优势。MRI能够正确显示非致密化范围。
超声心动图是检测NCVM的首选方法。在某些情况下，MRI可作为替代方法。在N/C比值超过2之前，不应考虑诊断为NCVM。
