Rajiah Prabhakar, Fulton Nicholas Lim, Bolen Michael
Department of Radiology, Cardiothoracic Imaging, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
Akron Radiology Inc, 525 E. Market Street, Akron, OH, 44304, USA.
Insights Imaging. 2019 Aug 19;10(1):83. doi: 10.1186/s13244-019-0761-3.
Left ventricular papillary muscles are small myocardial structures that play an important role in the functioning of mitral valve and left ventricle. Typically, there are two groups of papillary muscles, namely the anterolateral and the posteromedial groups. Cardiovascular magnetic resonance (CMR) is a valuable imaging modality in the evaluation of papillary muscles, providing both morphological and functional information. There is a remarkably wide variation in the morphology of papillary muscles. These variations can be asymptomatic or associated with symptoms related to LV outflow tract obstruction, often associated with hypertrophic cardiomyopathy. Abnormalities of the papillary muscles range from congenital disorders to neoplasms. Parachute mitral valve is the most common congenital abnormality of papillary muscles, in which all the chordae insert into a single papillary muscle. Papillary muscles can become dysfunctional, most commonly due to ischemia. Papillary muscle rupture is a major complication of acute myocardial infarction that results in mitral regurgitation and associated with high mortality rates. The most common papillary neoplasm is metastasis, but primary benign and malignant neoplasms can also be seen. In this article, we discuss the role of CMR in the evaluation of papillary muscle anatomy, function, and abnormalities.
左心室乳头肌是小的心肌结构，在二尖瓣和左心室的功能中起重要作用。通常有两组乳头肌，即前外侧组和后内侧组。心血管磁共振成像（CMR）是评估乳头肌的一种有价值的成像方式，可提供形态学和功能信息。乳头肌的形态存在显著差异。这些差异可能无症状，或与左心室流出道梗阻相关的症状有关，常与肥厚型心肌病相关。乳头肌异常范围从先天性疾病到肿瘤。降落伞样二尖瓣是乳头肌最常见的先天性异常，其中所有腱索均插入单一乳头肌。乳头肌可能会功能失调，最常见的原因是缺血。乳头肌破裂是急性心肌梗死的主要并发症，会导致二尖瓣反流，并伴有高死亡率。最常见的乳头肌肿瘤是转移瘤，但也可见原发性良性和恶性肿瘤。在本文中，我们讨论CMR在评估乳头肌解剖结构、功能及异常方面的作用。
