Arrivé L, Assayag P, Russ G, Najmark D, Brochet E, Nahum H
Department of Radiology, Hôpital Beaujon, Clichy, France.
J Comput Assist Tomogr. 1994 May-Jun;18(3):376-82. doi: 10.1097/00004728-199405000-00007.
This study was designed to determine MR and cine MR characteristics of asymmetric septal hypertrophic cardiomyopathy and to correlate MR and cine MR features with the severity of left ventricular outflow tract obstruction.
Ten consecutive patients with asymmetric septal hypertrophic cardiomyopathy [resting obstructive (n = 3), latent obstructive (n = 4), nonobstructive hypertrophic (n = 3)] and five healthy volunteers underwent MRI and cine MRI. Oblique two chamber and four chamber views were obtained in all cases.
In the 10 patients, the mean +/- SD end-diastolic myocardial thickness was 22.7 +/- 6.3 mm in the basal septum and 13 +/- 3.9 mm in the posterolateral wall with a ratio of 1.76 +/- 0.30; the corresponding values were 10.6 +/- 1.1, 10.4 +/- 1.1, and 1.02 +/- 0.08 mm, respectively, in five healthy volunteers. The mean systolic thickening of the basal septum was 22 +/- 12%. This value was 49 +/- 4% in the five healthy volunteers. In resting obstructive hypertrophic cardiomyopathy, septal wall thickness was > or = 25 mm with a systolic thickening of 10%. A systolic anterior motion of the mitral valve was demonstrated in four patients with resting subaortic pressure gradients ranging from 28 to 120 mm Hg. A signal void area was demonstrated within the left ventricular outflow tract during systole in the seven patients with obstructive cardiomyopathy. This signal void area reached its maximum during early systole in the most severe obstructions and during midsystole in the less severe obstructions.
In patients with asymmetric septal hypertrophic cardiomyopathy, gross correlation was demonstrated between severity of obstruction and several MR and cine MR features including increased end-diastolic thickness of the septal wall, decreased systolic thickening of the septal wall, systolic anterior motion of the mitral valve, and signal void area within the left ventricular outflow tract during systole.
本研究旨在确定不对称性室间隔肥厚型心肌病的磁共振成像（MR）及电影磁共振成像（cine MR）特征，并将MR及cine MR特征与左心室流出道梗阻的严重程度相关联。
连续10例不对称性室间隔肥厚型心肌病患者[静息梗阻性（n = 3）、潜在梗阻性（n = 4）、非梗阻性肥厚型（n = 3）]及5名健康志愿者接受了MRI及cine MRI检查。所有病例均获取了斜二腔和四腔视图。
10例患者中，基底室间隔舒张末期心肌厚度平均±标准差为22.7±6.3 mm，后外侧壁为13±3.9 mm，比值为1.76±0.30；5名健康志愿者相应的值分别为10.6±1.1、10.4±1.1和1.02±0.08 mm。基底室间隔平均收缩期增厚为22±12%。5名健康志愿者该值为49±4%。在静息梗阻性肥厚型心肌病中，室间隔壁厚度≥25 mm，收缩期增厚为10%。4例静息主动脉下压力梯度为28至120 mmHg的患者出现二尖瓣收缩期前向运动。7例梗阻性心肌病患者在收缩期左心室流出道内可见信号缺失区。在最严重梗阻时，该信号缺失区在收缩早期达到最大，在较轻梗阻时在收缩中期达到最大。
在不对称性室间隔肥厚型心肌病患者中，梗阻严重程度与多种MR及cine MR特征之间存在明显相关性，这些特征包括室间隔壁舒张末期厚度增加、室间隔壁收缩期增厚减少、二尖瓣收缩期前向运动以及收缩期左心室流出道内的信号缺失区。
