Magnetic resonance imaging for diagnosis of isolated left ventricular noncompaction
LIU Bo1, XU Jing1, GUAN Gong-chang1, MA Ai-qun2, LEI Xiao-yan1
1. Shaanxi People’s Hospital, Xi’an 710068, China;
2. Department of Cardiology,the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
摘要目的:探讨孤立性左心室心肌致密化不全(Isolated left ventricular noncompaction,ILVNC)心脏MRI的诊断特征。方法:2014年1—12月我院心内科门诊及住院患者共计8 895例行心脏超声心动图检查。排除其他合并疾病考虑ILVNC者行心脏MRI扫描,满足心脏超声及心脏MRI双重诊断标准及临床综合考虑纳入ILVNC组患者6例,分析临床资料及心脏MRI图像特点。结果:6例患者表现进行性心功能不全,伴有左心室扩大。ILVNC的心脏MRI诊断特征:左心室心肌分为两层,非致密化心肌层肌小梁粗大且排列不整齐,舒张末期可见隐窝充盈血液;心肌非致密化受累节段多,心尖部100%受累;舒张末期非致密化心肌与致密化心肌厚度比值超过2.3。结论:基于心脏MRI能够更准确全面展示非致密化心肌层可用于ILVNC诊断与鉴别,需要进一步行多中心大样本研究。
Abstract:Objective: To evaluate cardiac MRI for diagnosis of isolated left ventricular noncompaction(ILVNC). Methods: A total of 8 895 patients underwent echocardiography in our hospital from January to December 2014. Patients suspected to have ILVNC underwent cardiac MRI. Finally, six ILVNC patients were enrolled after a general consideration of manifestations of echocardiography, cardiac MRI and clinical data. Results: The clinical presentations of 6 ILVNC patients were heart failure with left ventricular enlargement. Cardiac MRI showed: two-layered myocardial structure with compacted and thickened noncompacted layer which consisted of trabecular meshing with deep endocardial spaces. The apex was involved in all cases. The intertrabecular recesses were perfused with blood at cardiac MRI end-diastole phase. The maximum end-diastole thickness ratio of noncompacted layer to compacted layer was more than 2.3. Conclusion: Cardiac MRI provides more accurate and reliable evaluation of noncompacted myocardium for ILVNC diagnosis. Further investigation is needed in large group of patients.