Rapezzi C, Fattori R, Castriota F, Passarelli P, Magnani G, Galiè N, Ferlito M, Bertaccini P, Branzi A, Gavelli G
Istituto di Malattie dell'Apparato Cardiovascolare, Università degli Studi, Bologna.
Cardiologia. 1994 Jan;39(1):7-15.
Clinical studies evaluating the role of magnetic resonance imaging (MRI) in patients with hypertrophic cardiomyopathy are scanty. To assess the capability of MRI to define the presence, distribution and severity of left ventricular hypertrophy, the prevalence and clinical implications of right ventricular hypertrophy, the prevalence and clinical implications of myocardial structural abnormalities, MRI and echocardiography were performed in 37 unselected patients (age 10-72 years, mean 38 +/- 19) with hypertrophic cardiomyopathy. The concordance between the two methods was 100% in the diagnosis and classification of left ventricular hypertrophy as asymmetric, concentric or apical. A significant linear correlation was found between echocardiography and MRI measurements of interventricular septum (r = 0.69, p < 0.0001, SEE = 4) and left ventricular posterior wall (r = 0.67, p < 0.0001, SEE = 2.4). Right ventricular hypertrophy (right anterior wall diastolic thickness > 5 mm) was disclosed by MRI in 23/33 patients (70%). In this group, left posterior wall thickness and left atrial diameter were higher (15 +/- 4 versus 11 +/- 2 mm, p < 0.01 and 45 +/- 9 versus 38 +/- 5 mm, p < 0.05 respectively). On T2 weighted sequences, areas of reduction of signal intensity, probably caused by myocardial fibrosis, were detected in 16 cases (43%). This group was characterized by a higher value in maximal septal thickness (26 +/- 7 versus 21 +/- 6 mm, p < 0.05) and in maximal left posterior wall thickness (15 +/- 9 versus 7 +/- 8 mm, p < 0.01). All the 3 cases with dilated and hypokinetic left ventricle showed this type of tissue abnormality.(ABSTRACT TRUNCATED AT 250 WORDS)
评估磁共振成像(MRI)在肥厚型心肌病患者中作用的临床研究较少。为了评估MRI确定左心室肥厚的存在、分布及严重程度、右心室肥厚的患病率及临床意义、心肌结构异常的患病率及临床意义的能力,对37例未经挑选的肥厚型心肌病患者(年龄10 - 72岁,平均38±19岁)进行了MRI和超声心动图检查。两种方法在左心室肥厚诊断及分类为不对称性、对称性或心尖部肥厚方面的一致性为100%。超声心动图与MRI测量的室间隔(r = 0.69,p < 0.0001,标准误 = 4)和左心室后壁(r = 0.67,p < 0.0001,标准误 = 2.4)之间存在显著线性相关性。MRI在23/33例患者(70%)中发现右心室肥厚(右前壁舒张期厚度>5 mm)。在该组中,左后壁厚度和左心房直径更高(分别为15±4对11±2 mm,p < 0.01;45±9对38±5 mm,p < 0.05)。在T2加权序列上,16例(43%)检测到可能由心肌纤维化导致的信号强度降低区域。该组的特征是最大室间隔厚度(26±7对21±6 mm,p < 0.05)和最大左后壁厚度(15±9对7±8 mm,p < 0.01)更高。所有3例左心室扩张和运动减弱的患者均显示出这种类型的组织异常。(摘要截断于250字)