Richter C, Richter K, Boewer V
Department of Radiology, Academy of Sciences of the GDR, Berlin.
Cor Vasa. 1990;32(4):290-301.
To identify their characteristic patterns, the X-ray dorso-ventral chest images of 118 patients with cardiomyopathy (63--dilated cardiomyopathy, 25--hypertrophic obstructive cardiomyopathy, 30--hypertrophic nonobstructive cardiomyopathy) were analyzed and compared with those of 22 patients without cardiac abnormalities. All 140 patients underwent comprehensive invasive cardiac examinations. In dilated and hypertrophic nonobstructive cardiomyopathy transvasal endomyocardial biopsy was performed. Irrespective of the type and the aetiology of cardiomyopathy, 4 characteristic patterns of X-ray findings could be identified: a class of left heart abnormality (class L) and 3 types of bilateral cardiac abnormalities with various stages of left heart failure (class L + R). An association between the image patterns and haemodynamic parameters (left ventricular end-diastolic pressure, wall mass index, pulmonary mean pressure) was demonstrated which was most obvious in dilated and less evident in hypertrophic obstructive cardiomyopathy. Mitral insufficiency in all types and classes frequently corresponded with the X-ray findings of left atrial enlargement. The X-ray classification method proved to be an efficient approach and superior to the heart-to-lung ratio.
为识别其特征性模式，对118例心肌病患者（63例扩张型心肌病、25例肥厚性梗阻性心肌病、30例肥厚性非梗阻性心肌病）的X线胸部正位片进行了分析，并与22例无心脏异常的患者的X线胸片进行了比较。所有140例患者均接受了全面的有创心脏检查。对于扩张型和肥厚性非梗阻性心肌病患者，进行了经静脉心内膜心肌活检。无论心肌病的类型和病因如何，均可识别出4种特征性的X线表现模式：一类左心异常（L类）和3种伴有不同程度左心衰竭的双侧心脏异常类型（L + R类）。已证实图像模式与血流动力学参数（左心室舒张末期压力、壁质量指数、肺平均压力）之间存在关联，这在扩张型心肌病中最为明显，而在肥厚性梗阻性心肌病中则不太明显。所有类型和类别的二尖瓣关闭不全常与左心房增大的X线表现相对应。X线分类方法被证明是一种有效的方法，优于心/肺比值。
