Department of Medical Biology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
Department of Biomedical Engineering and Physics, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
J Anat. 2022 Feb;240(2):357-375. doi: 10.1111/joa.13559. Epub 2021 Sep 26.
The ventricular walls of the human heart comprise an outer compact layer and an inner trabecular layer. In the context of an increased pre-test probability, diagnosis left ventricular noncompaction cardiomyopathy is given when the left ventricle is excessively trabeculated in volume (trabecular vol >25% of total LV wall volume) or thickness (trabecular/compact (T/C) >2.3). Here, we investigated whether higher spatial resolution affects the detection of trabeculation and thus the assessment of normal and excessively trabeculated wall morphology. First, we screened left ventricles in 1112 post-natal autopsy hearts. We identified five excessively trabeculated hearts and this low prevalence of excessive trabeculation is in agreement with pathology reports but contrasts the prevalence of approximately 10% of the population found by in vivo non-invasive imaging. Using macroscopy, histology and low- and high-resolution MRI, the five excessively trabeculated hearts were compared with six normal hearts and seven abnormally trabeculated and excessive trabeculation-negative hearts. Some abnormally trabeculated hearts could be considered excessively trabeculated macroscopically because of a trabecular outflow or an excessive number of trabeculations, but they were excessive trabeculation-negative when assessed with MRI-based measurements (T/C <2.3 and vol <25%). The number of detected trabeculations and T/C ratio were positively correlated with higher spatial resolution. Using measurements on high resolution MRI and with histological validation, we could not replicate the correlation between trabeculations of the left and right ventricle that has been previously reported. In conclusion, higher spatial resolution may affect the sensitivity of diagnostic measurements and in addition could allow for novel measurements such as counting of trabeculations.
人心室壁由外致密层和内小梁层组成。在增加的术前概率的情况下，如果左心室的体积（小梁容积>25%的总 LV 壁容积）或厚度（小梁/致密（T/C）>2.3）过度小梁化，则诊断为左室非致密性心肌病。在这里，我们研究了更高的空间分辨率是否会影响小梁的检测，从而影响对正常和过度小梁化壁形态的评估。首先，我们在 1112 例尸检心脏中筛选了左心室。我们确定了 5 例过度小梁化的心脏，这种过度小梁化的低患病率与病理报告一致，但与体内非侵入性成像发现的约 10%的人群患病率形成对比。使用大体解剖、组织学和低分辨率及高分辨率 MRI，将 5 例过度小梁化的心脏与 6 例正常心脏和 7 例异常小梁化且无过度小梁化的心脏进行比较。由于小梁流出或小梁数量过多，一些异常小梁化的心脏在大体解剖上可被认为是过度小梁化的，但当用基于 MRI 的测量（T/C<2.3 和 vol<25%）评估时，它们是过度小梁化阴性的。检测到的小梁数量和 T/C 比值与更高的空间分辨率呈正相关。使用高分辨率 MRI 上的测量值并进行组织学验证，我们无法复制以前报道的左心室和右心室小梁之间的相关性。总之，更高的空间分辨率可能会影响诊断测量的敏感性，并且还可以允许进行新的测量，例如小梁计数。
