Amano Yasuo, Takayama Morimasa, Kumita Shinichiro
Department of Radiology, Nippon Medical School, Tokyo, Japan.
J Magn Reson Imaging. 2009 Oct;30(4):778-84. doi: 10.1002/jmri.21921.
To assess the myocardial damage in hypertrophic cardiomyopathy (HCM) using contrast-enhanced myocardial T1-weighted scout (Look-Locker) magnetic resonance imaging (MRI).
Twenty-three patients with HCM and seven comparative patients without known HCM serving as controls underwent cine, contrast-enhanced myocardial T1-weighted scout and delayed-enhancement MRI using a 1.5T unit. Intervals of null points between myocardium and blood were compared among hyperenhancing and nullified myocardium of HCM and the normal myocardium. The relationship between these myocardial patterns and global cardiac functions was analyzed in HCM.
The hyperenhancing myocardium, dense myocardial fibrosis in HCM had null points significantly shorter than blood, normal myocardium, and nullified myocardium of HCM (P < 0.0001). The number of hyperenhancing myocardial segments correlated with the ejection fraction (P = 0.045). The nullified myocardium of HCM showed shorter intervals of the null points between myocardium and blood than did the normal myocardium, indicating the dispersed myocardial fibrosis (P = 0.0032). The interval of null points between the nullified myocardium and blood showed a significant correlation with the increase in myocardial mass in HCM (P = 0.034).
Contrast-enhanced myocardial T1-weighted scout imaging has the potential for showing dispersed myocardial damage leading to increased myocardial mass in HCM, while the dense myocardial fibrosis correlated with reduced ejection fraction.
使用对比增强心肌T1加权预备(Look-Locker)磁共振成像(MRI)评估肥厚型心肌病(HCM)中的心肌损伤。
23例HCM患者和7例无HCM的对照患者接受了电影成像、对比增强心肌T1加权预备成像和延迟增强MRI检查,使用1.5T设备。比较HCM的强化心肌和无强化心肌以及正常心肌中心肌与血液之间零点的间隔。分析HCM中这些心肌模式与整体心脏功能之间的关系。
HCM中强化的心肌,即致密的心肌纤维化,其零点间隔明显短于血液、正常心肌以及HCM的无强化心肌(P < 0.0001)。强化心肌节段的数量与射血分数相关(P = 0.045)。HCM的无强化心肌显示心肌与血液之间的零点间隔比正常心肌短,表明存在散在的心肌纤维化(P = 0.0032)。HCM中无强化心肌与血液之间的零点间隔与心肌质量增加显著相关(P = 0.034)。
对比增强心肌T1加权预备成像有潜力显示导致HCM中心肌质量增加的散在心肌损伤,而致密的心肌纤维化与射血分数降低相关。