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左心室心肌致密化不全患者的病理解剖、影像学和遗传学发现之间的相关性。

Correlation between pathoanatomic findings, imaging modalities, and genetic findings in patients with left ventricular hypertrabeculation/noncompaction.

机构信息

Klinik Landstraße, Wien, Austria.

出版信息

Expert Rev Cardiovasc Ther. 2021 Jul;19(7):595-606. doi: 10.1080/14779072.2021.1937128. Epub 2021 Jun 7.

Abstract

: Left ventricular hypertrabeculation, also named 'noncompaction' (LVHT) is a cardiac abnormality which is detected by pathoanatomic investigation or during cardiac surgery. Imaging techniques visualize LVHT by ventriculography, echocardiography, cardiac magnetic resonance imaging (CMRI) and computed tomography (CT).: We aimed to assess 1) how often the definition of LVHT was validated against a criterion standard, 2) if inter- and intra-observer agreement was assessed, and 3) how often LVHT was associated with genetic diseases. A literature search disclosed 58 cases whose hearts were investigated pathoanatomically and by ≥1 imaging technique. Echocardiography was most frequently (95%) compared with pathoanatomy, followed by cMRI (31%), ventriculography (7%) and CT (5%). Intra- and inter-observer agreement was more frequently assessed for cMRI definitions and yielded more consistent results than for echocardiographic definitions. Since genetic findings were only reported from 4 of the 58 cases, no association with imaging findings could be carried out.: Correlation between pathoanatomic investigations with imaging techniques will hopefully contribute to reliable and uniformly accepted definitions of LVHT. Most probably, the echocardiographic definition of LVHT will be a synthesis of the currently used definitions, integrating short axis and four-chamber views. A refinement of cMRI definitions, considering pathoanatomic and echocardiographic investigations, seems necessary to avoid overdiagnosis.

摘要

左心室心肌致密化不全,也称为“非致密化”(LVHT),是一种通过病理解剖研究或心脏手术发现的心脏异常。影像学技术通过心室造影、超声心动图、心脏磁共振成像(CMRI)和计算机断层扫描(CT)来可视化 LVHT。我们旨在评估 1)LVHT 的定义与标准对照的验证频率,2)是否评估了观察者内和观察者间的一致性,以及 3)LVHT 与遗传疾病的关联频率。文献检索发现了 58 例心脏经过病理解剖和至少 1 种影像学技术检查的病例。超声心动图的应用最广泛(95%),其次是 cMRI(31%)、心室造影(7%)和 CT(5%)。cMRI 定义的观察者内和观察者间一致性评估更频繁,结果也比超声心动图定义更一致。由于仅从 58 例中的 4 例报告了遗传发现,因此无法对其与影像学发现进行关联分析。希望病理解剖研究与影像学技术之间的相关性能够为 LVHT 的可靠和一致接受的定义做出贡献。LVHT 的超声心动图定义很可能是目前使用的定义的综合,整合短轴和四腔视图。为了避免过度诊断,似乎需要对 cMRI 定义进行细化,同时考虑病理解剖和超声心动图研究。

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