Amano Yasuo, Takeda Minako, Tachi Masaki, Kitamura Mitsunobu, Kumita Shinichiro
Department of Radiology, Nippon Medical School, Tokyo, Japan.
J Magn Reson Imaging. 2014 Aug;40(2):407-12. doi: 10.1002/jmri.24357. Epub 2013 Oct 29.
To evaluate the distribution and extent of myocardial fibrosis identified by either contrast-enhanced Look-Locker or late gadolinium enhancement magnetic resonance imaging (LGE MRI) and their relationships between ventricular tachyarrhythmia or risk factors in apical hypertrophic cardiomyopathy (APH).
Twenty-five APH patients were examined using a 3.0 T or 1.5 T instrument. We used MRI to evaluate myocardial T1 values and scar. We compared the myocardial fibrosis assessed by contrast-enhanced Look-Locker or LGE MRI with ventricular tachyarrhythmia or risk factors for hypertrophic cardiomyopathy.
Myocardial scar was present in 17 of the 25 patients with APH. Myocardial scar was distributed predominantly in the apical myocardium (P < 0.01), whereas myocardial T1 values did not differ between the apical, midventricular, and basal septum. The extent of myocardial scar according to 16-segment model and ejection fraction were related to ventricular tachyarrhythmia or risk factors in APH (P < 0.05 for both). The myocardial T1 value was not associated with the tachyarrhythmia or risk factors.
In APH, the extent of myocardial scar on LGE MRI is associated with ventricular tachyarrhythmia and risk factors. Quantification of the myocardial T1 value is not necessary for its risk stratification.
通过对比增强Look-Locker或延迟钆增强磁共振成像（LGE MRI）评估肥厚型心肌病（APH）中心肌纤维化的分布和范围，以及它们与室性心律失常或危险因素之间的关系。
使用3.0T或1.5T仪器对25例APH患者进行检查。我们使用MRI评估心肌T1值和瘢痕。我们将通过对比增强Look-Locker或LGE MRI评估的心肌纤维化与室性心律失常或肥厚型心肌病的危险因素进行比较。
25例APH患者中有17例存在心肌瘢痕。心肌瘢痕主要分布于心尖部心肌（P<0.01），而心尖、心室中部和基底间隔的心肌T1值无差异。根据16节段模型和射血分数得出的心肌瘢痕范围与APH中的室性心律失常或危险因素相关（两者均P<0.05）。心肌T1值与心律失常或危险因素无关。
在APH中，LGE MRI上的心肌瘢痕范围与室性心律失常和危险因素相关。对其进行风险分层时，无需对心肌T1值进行量化。
