Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Radiology, Halkali/Istanbul, Turkey.
Istanbul Acibadem Mehmet Ali Aydinlar University, Department of Radiology, Istanbul, Turkey.
Clin Imaging. 2020 Oct;66:121-126. doi: 10.1016/j.clinimag.2020.04.024. Epub 2020 May 4.
Subendocardial fibrosis is recognized finding in left ventricular noncompaction (LVNC); however, the evidence regarding the patterns and the frequency of late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMRI) is controversial. The present study sought to assess the frequency and patterns of LGE in LVNC.
Patients with a diagnosis of LVNC based on the echocardiographic CMRI criteria were enrolled in this retrospective study. The myocardial noncompacted-to-compacted ratio (NC/C) was perpendicularly measured on short-axis cine images. Two observers jointly assessed the presence of LGE on short-axis LGE images. The long-axis four-chamber and long-axis two-chamber images were used to confirm the presence of LGE if needed.
A total of 42 patients, 20 females (47.7%) and 22 were males (52.3%), were included in the study. The median age of the patients was 32.4 years (range 18-63). LGE was identified in 2 out of 42 patients (4.7%) with LVNC. LGE was identified in the interventricular septum involving the subendocardial layer and noncompacted lateral myocardial wall involving the trabeculae at mid-ventricular and basal levels.
LGE is uncommon in patients with LVNC. We highlight that the diagnosis of LVNC in patients with atypical LGE patterns, such as epicardial or transmural enhancement, should be reappraised and the other cardiac diseases should be discarded before establishing the final diagnosis.
心内膜下纤维化是左心室致密化不全（LVNC）的一种公认表现；然而，关于心脏磁共振成像（CMRI）上晚期钆增强（LGE）的模式和频率的证据存在争议。本研究旨在评估 LVNC 中的 LGE 频率和模式。
本回顾性研究纳入了根据超声心动图 CMRI 标准诊断为 LVNC 的患者。在短轴电影图像上垂直测量心肌非致密化与致密化比值（NC/C）。两名观察者共同评估短轴 LGE 图像上 LGE 的存在。如果需要，使用长轴四腔和长轴两腔图像来确认 LGE 的存在。
共有 42 名患者，20 名女性（47.7%）和 22 名男性（52.3%）纳入了本研究。患者的中位年龄为 32.4 岁（范围 18-63 岁）。在 42 名 LVNC 患者中，有 2 名（4.7%）发现 LGE。LGE 位于室间隔心内膜下层和非致密化侧壁心外膜下层，累及中室间隔和基底水平的小梁。
LGE 在 LVNC 患者中不常见。我们强调，对于 LGE 模式不典型（如心外膜或透壁增强）的 LVNC 患者，在确立最终诊断之前，应重新评估并排除其他心脏疾病。
