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应用心脏磁共振成像测量左心室小梁化质量在左心室致密化不全的诊断中的应用。

Measurement of trabeculated left ventricular mass using cardiac magnetic resonance imaging in the diagnosis of left ventricular non-compaction.

机构信息

Department of Radiology, University of Marseille Méditerranée CHU la Timone, 264 rue St Pierre, 13385 Marseille Cedex 05, France.

出版信息

Eur Heart J. 2010 May;31(9):1098-104. doi: 10.1093/eurheartj/ehp595. Epub 2010 Jan 19.

Abstract

AIMS

To describe a method for measuring trabeculated left ventricular (LV) mass using cardiac magnetic resonance imaging and to assess its value in the diagnosis of left ventricular non-compaction (LVNC).

METHODS AND RESULTS

Between January 2003 and 2008, we prospectively included 16 patients with LVNC. During the mean period, we included 16 patients with dilated cardiomyopathy (DCM), 16 patients with hypertrophic cardiomyopathy (HCM), and 16 control subjects. Left ventricular volumes, LV ejection fraction, and trabeculated LV mass were measured in the four different populations. The percentage of trabeculated LV mass was almost three times higher in the patients with LVNC (32 +/- 10%), compared with those with DCM (11 +/- 4%, P < 0.0001), HCM (12 +/- 4%, P < 0.0001), and controls (12 +/- 5%, P < 0.0001). A value of trabeculated LV mass above 20% of the global mass of the LV predicted the diagnosis of LVNC with a sensitivity of 93.7% [95% confidence interval (CI), 71.6-98.8%] and a specificity of 93.7% (95% CI, 83.1-97.8%; kappa = 0.84).

CONCLUSION

The method described is reproducible and provides an assessment of the global amount of LV trabeculation. A trabeculated LV mass above 20% of the global LV mass is highly sensitive and specific for the diagnosis of LVNC.

摘要

目的

描述一种使用心脏磁共振成像测量小梁化左心室(LV)质量的方法,并评估其在诊断左心室致密化不全(LVNC)中的价值。

方法和结果

2003 年 1 月至 2008 年期间,我们前瞻性纳入了 16 例 LVNC 患者。在此期间,我们纳入了 16 例扩张型心肌病(DCM)患者、16 例肥厚型心肌病(HCM)患者和 16 例对照者。在这 4 组人群中测量左心室容积、LV 射血分数和小梁化 LV 质量。LVNC 患者的小梁化 LV 质量百分比几乎是 DCM 患者(11%±4%,P<0.0001)、HCM 患者(12%±4%,P<0.0001)和对照组(12%±5%,P<0.0001)的 3 倍。小梁化 LV 质量超过 LV 整体质量的 20%预测 LVNC 的诊断,其敏感性为 93.7%(95%可信区间,71.6%98.8%),特异性为 93.7%(95%可信区间,83.1%97.8%;kappa=0.84)。

结论

所描述的方法具有可重复性,并提供了对 LV 小梁整体数量的评估。小梁化 LV 质量超过 LV 整体质量的 20%高度敏感且特异性地诊断 LVNC。

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