Yu Jin-chao, Zhao Shi-hua, Jiang Shi-liang, Wang Li-ming, Wang Zhen-fu, Lu Min-jie, Ling Jian, Zhang Yan, Yan Chao-wu, Liu Qiong, Cheng Huai-bing
Department of Radiology, Cardiovasular Institute and Fuwai Hospital, Chinese Academy and Medical Science, Peking Union Medical College, Beijing 100037, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2010 May;38(5):392-7.
To characterize the clinical and cardiac MRI features of dilated cardiomyopathy (DCM) and left ventricular noncompaction (LVNC).
Compared the clinical and MRI features between 25 patients with LVNC and 21 patients with DCM. The MRI derived diastolic left ventricular wall thickness and the number and degree of noncompaction (NC) were evaluated using the 17-segment model.
Chest distress, shortness of breath and abnormal ECG were presented in all DCM patients, abnormal ECG was evidenced in 22 LVNC patients and 21 out of 25 LVNC patients presented similar clinical symptoms as DCM patients while the rest 4 LVNC patients were asymptomatic. Left atrial and ventricular dimensions were significantly smaller in LVNC patients compared to DCM patients. The degree of left ventricular (LV) spherical remodeling was significantly greater in patients with DCM (sphericity index, SI = 0.81 +/- 0.06) than in patients with LVNC (SI = 0.74 +/- 0.11, P < 0.05). The LV ejection fraction (LVEF) was significantly higher in patients with LVNC (32.7% +/- 14.2%) than that in patients with DCM (15.0% +/- 5.1%). The number of NC segments in LVNC patients (9 +/- 1) was significantly higher than the number of hypertrabeculation segment in DCM patients (5 +/- 2). The left ventricular apex (the 17th segment) was unexceptionally involved in all LVNC patients, while hypertrabeculation was absent in the 17th segment of DCM patients. The NC was more common in the apical and mid segments (16th, 12th and 11th segments) than in basal and mid septal segments (2nd, 3rd, 8th and 9th segments) in both LVNC and DCM patients. The thickness of compacted myocardium of the segments associated with noncompaction appeared thin in two groups. The wall thickness of noncompaction myocardium segments was thicker in LVNC patients than in DCM patients. The end-diastolic NC/C ratio was, on average, higher in patients with LVNC (3.3 +/- 0.6) than in patients with DCM (1.9 +/- 0.3).
The clinical manifestation is similar while there are significant differences in the morphology and function of left atria and left ventricle between the LVNC and DCM patients. The different distribution and degree of NC were helpful to differentiate LVNC from DCM.
描述扩张型心肌病（DCM）和左心室心肌致密化不全（LVNC）的临床及心脏磁共振成像（MRI）特征。
比较25例LVNC患者和21例DCM患者的临床及MRI特征。采用17节段模型评估MRI得出的舒张期左心室壁厚度以及心肌致密化不全（NC）的节段数和程度。
所有DCM患者均有胸闷、气短及心电图异常；22例LVNC患者有心电图异常，25例LVNC患者中有21例表现出与DCM患者相似的临床症状，其余4例LVNC患者无症状。与DCM患者相比，LVNC患者的左心房和心室尺寸明显较小。DCM患者的左心室（LV）球形重构程度（球形指数，SI = 0.81±0.06）显著高于LVNC患者（SI = 0.74±0.11，P < 0.05）。LVNC患者的左心室射血分数（LVEF）（32.7%±14.2%）显著高于DCM患者（15.0%±5.1%）。LVNC患者的NC节段数（9±1）显著高于DCM患者的肌小梁增多节段数（5±2）。所有LVNC患者的左心室心尖部（第17节段）均无一例外受累，而DCM患者的第17节段无肌小梁增多。在LVNC和DCM患者中，NC在尖段和中段（第16、12和11节段）比在基底段和中隔段（第2、3、8和9节段）更常见。两组中与致密化不全相关节段的致密心肌厚度均显得较薄。LVNC患者致密化不全心肌节段的壁厚度比DCM患者厚。LVNC患者的舒张末期NC/C比值平均（3.3±0.6）高于DCM患者（1.9±0.3）。
LVNC和DCM患者临床表现相似，但左心房和左心室的形态及功能存在显著差异。NC的不同分布和程度有助于LVNC与DCM的鉴别。
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