Radiologia, Ospedale San Bassiano, Via dei Lotti 61, 36060, Bassano del Grappa, Italy.
Radiol Med. 2011 Mar;116(2):197-210. doi: 10.1007/s11547-010-0603-3. Epub 2010 Oct 27.
Hypertrophic cardiomyopathy (HCM) is a hereditary disease characterised by primary hypertrophy of the left and/or right ventricle. The reference standard for imaging diagnosis is echocardiography. The aim of our study was to prospectively compare the diagnostic accuracy of echocardiography and cardiac magnetic resonance (MR) imaging in patients with HCM.
Twenty-two consecutive patients with a known diagnosis of HCM were prospectively evaluated, with echocardiography and cardiac MR imaging performed within 2 weeks of each other (mean interval 7 days, range 2-14 days). Two experienced radiologists blinded to the previous clinical and imaging findings separately reviewed the images. The following parameters were calculated for both techniques: myocardial mass, wall thickness, end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), systolic anterior motion (SAM) of the mitral valve and degree of myocardial fibrosis (based on the ultrasonic reflectivity at echocardiography and degree of late enhancement at cardiac MR imaging). The statistical correlation was calculated with Student's t test, Spearman coefficient and Fisher's exact test. A value of p<0.05 was considered significant.
The diagnosis of HCM was confirmed in all patients with both techniques, with absolute agreement in terms of the site of disease. The mean value of myocardial mass presented a statistically significant difference between the two techniques (114 g, p<0.001). In contrast, a nonsignificant difference between echocardiography and cardiac MR imaging was found for EDV (102 ml vs 111 ml; p=0.31), ESV (30 ml vs 38 ml; p=0.1), EF (74% vs 68%, p=0.5), SAM (p=0.1) and myocardial fibrosis (p=0.15).
Cardiac MR imaging correlates well with echocardiography in defining the morphological and functional parameters useful for the imaging diagnosis of HCM and therefore, in selected cases (poor acoustic window, doubtful echocardiography findings), it may be a valid alternative to echocardiography.
肥厚型心肌病（HCM）是一种以左心室和/或右心室原发性肥厚为特征的遗传性疾病。影像学诊断的参考标准是超声心动图。本研究的目的是前瞻性比较超声心动图和心脏磁共振成像（CMR）在 HCM 患者中的诊断准确性。
连续 22 例已知 HCM 诊断的患者前瞻性评估，超声心动图和心脏磁共振成像在 2 周内完成（平均间隔 7 天，范围 2-14 天）。两位经验丰富的放射科医生对图像进行独立评估，他们对之前的临床和影像学发现不知情。分别计算了两种技术的以下参数：心肌质量、壁厚度、舒张末期容积（EDV）、收缩末期容积（ESV）、射血分数（EF）、二尖瓣收缩期前向运动（SAM）和心肌纤维化程度（基于超声心动图的超声反射率和心脏磁共振成像的晚期增强程度）。采用学生 t 检验、斯皮尔曼系数和 Fisher 确切检验计算统计学相关性。p<0.05 被认为具有统计学意义。
所有患者均通过两种技术确诊 HCM，疾病部位完全一致。两种技术的心肌质量平均值存在统计学差异（114g，p<0.001）。相反，超声心动图和心脏磁共振成像的 EDV（102ml 比 111ml；p=0.31）、ESV（30ml 比 38ml；p=0.1）、EF（74%比 68%，p=0.5）、SAM（p=0.1）和心肌纤维化（p=0.15）无显著差异。
心脏磁共振成像与超声心动图在定义 HCM 影像学诊断有用的形态和功能参数方面具有良好的相关性，因此，在某些情况下（超声窗差、超声心动图结果可疑），它可能是超声心动图的有效替代方法。
