Fattori R, Castriota F, Bertaccini P, Celletti F, Boriani G, Sangiorgio P, Gavelli G
Istituto di Radiologia (IIa Cattedra), Policlinico S. Orsola Malpighi, Bologna.
G Ital Cardiol. 1996 May;26(5):483-93.
Magnetic Resonance (MR) imaging gives information about the complex anatomy of the right ventricle (RV). Because of the capability of tissue characterization, in addition to the functional and morphologic analysis, MR imaging is an optimal technique to investigate patients (pts) with clinical suspicion of arrhythmogenic right ventricular dysplasia (ARVD).
The purpose of the current study was to investigate a group of 55 pts with ventricular arrhythmias in order to detect ARVD. MR was performed with a 0.5 magnet (MR MAX PLUS G:E. Medical System). Electrocardiographically gated spin-echo and gradient-echo MR images of the heart were obtained in both transverse and sagittal planes. Sustained ventricular tachycardia (SVT) was present in 14 pts, non sustained ventricular tachycardia (NSVT) in 13 pts, left bundle block ventricular premature complexes > 10000/24 h (VPC/LBB) in 28 pts. The abnormalities analyzed were: presence of focal or diffuse fatty replacement of myocardium, segmental or global dilation of the RV, reduction of ejection fraction with akinetic or dyskinetic areas, disarrangement of the trabecular pattern with the hypertrophy of the moderator band.
When intramyocardial fatty replacement and at least two of the abnormalities were present we considered the MR aspects compatible with the diagnosis of ARVD. We detected the presence of ARVD in 8/14 pts with SVT, in 4/13 pts with NSVT, in 4/28 pts VPC/LBB: In 10/16 pts with ARVD left ventricular abnormalities (areas of fatty replacement of the myocardial wall and/or reduction of ejection fraction) were also present. The left ventricular involvement was detected in 5 pts with SVT, in 2 pts with NSVT, in 3 pts with VPC/LBB: Even if in 31 pts it was not possible to identify aspects compatible with the diagnosis of ARVD, some structural abnormalities of RV were also present. Because of its non-invasiveness MR is an excellent technique for the detection of ARVD, and of minor right ventricular abnormalities.
磁共振（MR）成像可提供有关右心室（RV）复杂解剖结构的信息。由于具备组织特征分析能力，除功能和形态分析外，MR成像还是用于研究临床怀疑有心律失常性右心室发育不良（ARVD）患者的最佳技术。
本研究旨在调查一组55例室性心律失常患者以检测ARVD。使用0.5磁体（MR MAX PLUS G：E. Medical System）进行MR检查。在横断和矢状面获取心脏的心电图门控自旋回波和梯度回波MR图像。14例患者存在持续性室性心动过速（SVT），13例患者存在非持续性室性心动过速（NSVT），28例患者左束支阻滞室性早搏复合体>10000/24小时（VPC/LBB）。分析的异常包括：心肌局灶性或弥漫性脂肪替代、RV节段性或整体扩张、射血分数降低伴运动减弱或运动障碍区域、小梁结构紊乱伴节制索肥厚。
当存在心肌内脂肪替代以及至少两项异常时，我们认为MR表现符合ARVD诊断。我们在14例SVT患者中的8例、13例NSVT患者中的4例、28例VPC/LBB患者中的4例检测到ARVD存在：在16例ARVD患者中的10例还存在左心室异常（心肌壁脂肪替代区域和/或射血分数降低）。在5例SVT患者、2例NSVT患者、3例VPC/LBB患者中检测到左心室受累：即使在31例患者中无法识别符合ARVD诊断的表现，但也存在一些RV结构异常。由于其非侵入性，MR是检测ARVD以及轻微右心室异常的优秀技术。
