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钆喷酸葡胺增强磁共振成像检测肥厚型心肌病左心室心肌异常高信号强度的临床意义

[Clinical significance of abnormal high signal intensity of left ventricular myocardium by gadolinium-diethylenetriaminepenta-acetic acid enhanced magnetic resonance imaging in hypertrophic cardiomyopathy].

作者信息

Koito H, Suzuki J, Nakamori H, Ohkubo N, Wakayama Y, Iwasaka T, Inada M, Katoh T

机构信息

Second Department of Internal Medicine, Kansai Medical University, Osaka.

出版信息

J Cardiol. 1995 Apr;25(4):163-70.

PMID:7752050
Abstract

The significance of abnormal high signal intensity observed in left ventricular myocardium by gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) enhanced magnetic resonance (MR) imaging in hypertrophic cardiomyopathy (HCM) patients was assessed by comparison with T1-weighted MR imaging, thallium-201 (201Tl) myocardial scintigraphy, radionuclide angiocardiography, M-mode echocardiography, electrocardiography, and chest radiography. The 16 patients were divided into three groups: 8 patients (group I) with abnormal high signal intensity before and after Gd-DTPA enhancement, 4 (group II) with abnormal high signal intensity only after enhancement and 4 (group III) without abnormal high signal intensity. Thallium-201 myocardial single photon emission computed tomography (SPECT) showed 4 of the 8 patients in group I, 3 of the 4 patients in group II and only 1 of the 4 patients in group III had abnormalities of regional 201Tl uptake in the left ventricular myocardium. No significant difference in left ventricular ejection fraction (LVEF) was seen between groups I, II, and III (64 +/- 13%, 67 +/- 17% and 71 +/- 7%, respectively) although three patients of group I had LVEF of less than 55%. Left ventricular peak filling rates (PFR) of groups I and II were significantly lower than that of group III (1.90 +/- 0.44, 2.41 +/- 0.43 and 3.37 +/- 0.48 EDV/sec, respectively). Group I had larger end-diastolic left ventricular dimension (LVDd), significantly larger end-systolic left ventricular dimension (LVDs), and smaller % fractional shortening (%FS) than group III (49 +/- 4 vs 42 +/- 6 mm, 31 +/- 5 vs 22 +/- 4 mm, and 38 +/- 8 vs 49 +/- 4%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

通过钆-二乙烯三胺五乙酸(Gd-DTPA)增强磁共振(MR)成像观察肥厚型心肌病(HCM)患者左心室心肌中异常高信号强度的意义,通过与T1加权MR成像、铊-201(201Tl)心肌闪烁显像、放射性核素心血管造影、M型超声心动图、心电图和胸部X线摄影进行比较来评估。16例患者分为三组:8例(I组)Gd-DTPA增强前后均有异常高信号强度,4例(II组)仅增强后有异常高信号强度,4例(III组)无异常高信号强度。铊-201心肌单光子发射计算机断层扫描(SPECT)显示,I组8例患者中有4例、II组4例患者中有3例、III组4例患者中仅有1例左心室心肌区域201Tl摄取异常。I、II、III组之间左心室射血分数(LVEF)无显著差异(分别为64±13%、67±17%和71±7%),尽管I组有3例患者LVEF低于55%。I组和II组的左心室峰值充盈率(PFR)显著低于III组(分别为1.90±0.44、2.41±0.43和3.37±0.48 EDV/秒)。I组舒张末期左心室内径(LVDd)更大,收缩末期左心室内径(LVDs)显著更大,缩短分数百分比(%FS)比III组更小(分别为49±4对42±6毫米、31±5对22±4毫米、38±8对49±4%)。(摘要截断于250字)

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