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目的探讨心脏MRI检查在致心律失常性右室心肌病(arrhythmogenic right ventricular cardiomyopathy,ARVC)诊断中的应用价值。方法收集2005年1月至2008年5月在我院就诊的9例ARVC患者。所有患者行MRI检查,使用美国GE SIGNA 1.5T超导磁共振成像仪及8通道心脏线圈,行MR多序列、多方位、多功能成像技术检查。采用“白血技术”作四腔心,心脏短轴及左右室长轴位电影磁共振成像(cine MRI)。采用“黑血技术”即双反转恢复快速自旋回波(Doub1e-IRFSE)和三反转恢复快速自旋回波(Triple-IRFSE)序列行短轴及右室长轴扫描。结果本研究9例患者右室壁均有不同程度变薄,右室腔扩大8例。1例见室间隔略厚,左室腔扩大2例。其中3例在DIRFSE序列右室心肌出现灶状高信号,而在TIRFSE序列中,出现不规则岛状或连续中断影像。部位包括右室心尖部6例、膈面4例、前壁4例、漏斗部4例,其中1例累及乳头肌。右室流出道扩张2例,局部反向搏动、室壁瘤2例。结论心脏MRI检查能反映出结构及功能的改变,清晰地显示患者病变的性质、程度及范围,是目前诊断ARVC的一项最具特异性和敏感性的无创性检查方法,对于临床上怀疑该病的患者应常规行该项检查。
Objective To investigate the value of cardiac MRI in the diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods Nine patients with ARVC who were treated in our hospital from January 2005 to May 2008 were collected. All patients underwent MRI examination, using the US GE SIGNA 1.5T superconducting magnetic resonance imaging and 8-channel cardiac coil MR multi-sequence, multi-directional, multi-functional imaging examination. The use of “white blood technology” for four-chamber heart, short axis of the heart and left and right axial Cine MRI (cine MRI). The short axis and right ventricular long axis scan were performed using the “black blood technique”, ie, double-inversion fast spin echo (Doub1e-IRFSE) and triple-IRFSE sequences. Results The right ventricular wall of 9 patients in this study were all thinned to varying degrees, and the right ventricular cavity was enlarged in 8 cases. 1 case, see slightly thicker interventricular septum, left ventricular cavity expansion in 2 cases. Three of them showed focal hyperintensity in the right ventricular myocardium in the DIRFSE sequence, while irregular island-shaped or discontinuous images appeared in the TIRFSE sequence. Including the right ventricular apex in 6 cases, 4 cases of the diaphragm, the anterior wall in 4 cases, 4 cases of funnel, including 1 case involving the papillary muscle. Right ventricular outflow tract expansion in 2 cases, local reverse beating, 2 cases of aneurysm. Conclusion Cardiac MRI examination can reflect the change of structure and function, clearly show the nature, degree and scope of the patient’s lesion. It is the most specific and sensitive non-invasive method for the diagnosis of ARVC. For clinical suspicion Sick patients should routinely conduct the test.