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比较成人孤立性左心室致密化不全与扩张型心肌病的心脏磁共振成像特征。

Comparison of cardiac magnetic resonance imaging features of isolated left ventricular non-compaction in adults versus dilated cardiomyopathy in adults.

机构信息

Department of Radiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

出版信息

Clin Radiol. 2011 Sep;66(9):853-60. doi: 10.1016/j.crad.2011.04.014.

Abstract

AIM

To compare cardiac magnetic resonance imaging (MRI) features between isolated left ventricular non-compaction (IVNC) and dilated cardiomyopathy (DCM) in adults.

MATERIALS AND METHODS

A consecutive series of 50 patients with IVNC from a single institution were reviewed. During the same period, 50 patients with DCM who had prominent trabeculations, who were matched for age, gender, and body surface area, were prospectively included. Left ventricular (LV) morphology and function were assessed using cardiac MRI.

RESULTS

Compared with patients with DCM, patients with IVNC had a significantly lower LV sphericity index and end-diastolic volume index (LVEDVI) and a greater LV ejection fraction (LVEF), number of trabeculated segments, and ratio of non-compacted to compacted myocardium (NC/C ratio). There were no significant differences in stroke volume index, cardiac output, and cardiac index between the two patient groups. In patients with IVNC, the number of trabeculated segments and the NC/C ratio correlated positively with LVEDVI (r=0.626 and r=0.559, respectively) and negatively with LVEF (r=-0.647 and r=-0.521, respectively, p<0.001 for all). In patients with DCM, the number of non-compacted segments and the NC/C ratio had no correlation with either the LVEDVI (r=-0.082 and r=-0.135, respectively) or the LVEF (r=0.097 and r=0.205, respectively).

CONCLUSION

There are demonstrable morphological and functional differences between IVNC and DCM at LV assessment using cardiac MRI. The occurrence of trabeculated myocardium might be due to a different pathophysiological mechanism.

摘要

目的

比较孤立性左心室心肌致密化不全(IVNC)与扩张型心肌病(DCM)患者的心脏磁共振成像(MRI)特征。

材料与方法

回顾性分析了一家医疗机构连续收治的 50 例 IVNC 患者。同期前瞻性纳入了 50 例伴有明显小梁心肌的 DCM 患者,两组患者按年龄、性别和体表面积匹配。采用心脏 MRI 评估左心室(LV)形态和功能。

结果

与 DCM 患者相比,IVNC 患者的 LV 球形指数和舒张末期容积指数(LVEDVI)明显更低,而左心室射血分数(LVEF)、小梁心肌节段数和非致密心肌与致密心肌比值(NC/C 比值)更高。两组患者的每搏输出量指数、心输出量和心指数均无显著差异。在 IVNC 患者中,小梁心肌节段数和 NC/C 比值与 LVEDVI 呈正相关(r 值分别为 0.626 和 0.559),与 LVEF 呈负相关(r 值分别为-0.647 和-0.521,p<0.001)。在 DCM 患者中,非致密心肌节段数和 NC/C 比值与 LVEDVI(r 值分别为 0.082 和 0.135)或 LVEF(r 值分别为 0.097 和 0.205)均无相关性。

结论

心脏 MRI 评估 LV 时,IVNC 与 DCM 存在明显的形态学和功能差异。小梁心肌的发生可能源于不同的病理生理机制。

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