Sardanelli F, Molinari G, Petillo A, Ottonello C, Parodi R C, Masperone M A, Saitta S, Basso M, Caponnetto S
Department of Radiology, Genova University, Italy.
J Comput Assist Tomogr. 1993 Nov-Dec;17(6):862-72. doi: 10.1097/00004728-199311000-00005.
We compared MRI with two-dimensional echocardiography (2dE) and Doppler echocardiography to determine the diagnostic role of MRI in hypertrophic cardiomyopathy (HCM).
Twenty-three patients with 2dE diagnosis of HCM were examined with MRI; 12 of 23 patients were also studied by color (cDE) and continuous wave (cwDE) Doppler echocardiography. Morphologic information and diastolic heart wall thickness were obtained by SE sequences; functional study was performed by gradient echo sequences (cine MR).
The correlation between MR, SE sequences and 2dE was better for septal (r = 0.930, p < 0.01) than for posterolateral (r = 0.739, p < 0.01) wall thickness. The assessment of the distribution of the hypertrophy was changed by MR in five cases. Cine MR functional study showed a systolic subaortic signal void (dynamic obstruction) in 12 of 22 patients and a systolic left atrial signal void (mitral regurgitation) in 17 of 22. Systolic wall thickening was studied by cine MR and 2dE in 11 patients: A good correlation was found for septum (0.01 < p < 0.05) and a poor one for posterolateral wall (p > 0.05). The cine MR and cDE turbulence duration in the left ventricle and atrium showed excellent correlation (p < 0.01). Good agreement was found between the duration of subaortic turbulence (cine MR or cDE) and the pressure gradient (cwDE) (p < 0.01 and 0.01 < p < 0.05, respectively) and between cine MR and cDE semiquantitative estimate of the mitral regurgitation (p < 0.01). In all patients with subaortic MR signal void studied with cwDE, a pressure gradient was present.
Magnetic resonance imaging can play an important role in the diagnosis of HCM after 2dE-DE.
我们将磁共振成像（MRI）与二维超声心动图（2dE）及多普勒超声心动图进行比较，以确定MRI在肥厚型心肌病（HCM）诊断中的作用。
对23例经2dE诊断为HCM的患者进行MRI检查；23例患者中的12例还接受了彩色（cDE）和连续波（cwDE）多普勒超声心动图检查。通过自旋回波（SE）序列获取形态学信息和舒张期心脏壁厚度；通过梯度回波序列（电影磁共振成像）进行功能研究。
对于室间隔厚度，MR、SE序列与2dE之间的相关性（r = 0.930，p < 0.01）优于后外侧壁厚度（r = 0.739，p < 0.01）。MR改变了5例患者肥厚分布的评估。电影磁共振成像功能研究显示，22例患者中有12例存在收缩期主动脉下信号缺失（动态梗阻），22例中有17例存在收缩期左心房信号缺失（二尖瓣反流）。对11例患者通过电影磁共振成像和2dE研究收缩期心肌增厚：发现室间隔有良好相关性（0.01 < p < 0.05），而后外侧壁相关性较差（p > 0.05）。电影磁共振成像和cDE测量的左心室和心房内湍流持续时间显示出极佳的相关性（p < 0.01）。主动脉下湍流持续时间（电影磁共振成像或cDE）与压力阶差（cwDE）之间（分别为p < 0.01和0.01 < p < 0.05）以及电影磁共振成像和cDE对二尖瓣反流的半定量评估之间（p < 0.01）均发现有良好的一致性。在所有接受cwDE检查的主动脉下MR信号缺失患者中均存在压力阶差。
在二维超声心动图 - 多普勒超声心动图（2dE - DE）之后，磁共振成像在肥厚型心肌病的诊断中可发挥重要作用。
