论文部分内容阅读
目的评估 MRI 诊断心尖肥厚型心肌病的应用价值。方法应用 MR 检测心尖肥厚型心肌病。所有患者均行超声心动图和心电图检查,其中16例患者行核素心肌显像,34例患者行冠状动脉及左室造影。另取26名正常人为对照组进行对比分析。结果共发现心尖肥厚型心肌病116例,占同期肥厚性心肌病的21.2%(116/547),其中典型心尖肥厚型心肌病(T-AHCM)65例,早期心尖肥厚型心肌病(P-AHCM)51例。T-AHCM 组和 P-AHCM 组的心尖部室壁厚度分别为(18.6±2.7)mm 与(13.6±1.0)mm;心尖部室壁厚度/基底段后壁厚度的比值分别为2.2±0.5与1.6±0.3,均显著高于正常组的(9.5±1.7)mm 和1.1±0.1,T-AHCM 组与 P-AHCM 组比较差异有统计学意义(t 值分别为4.23和7.55,P 值均<0.05)。室壁增厚率 T-AHCM 组为(27.7±6.7)%,P-AHCM 组为(41.2±9.2)%,对照组为(80.6±6.6)%,患者组与对照组比较差异有统计学意义(t 值分别为9.45和7.18,P 值均<0.05)。胸前超声心动图 T-AHCM 组漏诊率为76.9%(50/65),P-AHCM 组的漏诊率达90.2%(46/51)。结论 MRI 能够准确诊断心尖肥厚型心肌病,对早期轻型患者的诊断价值优于超声心动图。
Objective To evaluate the value of MRI in diagnosis of apical hypertrophic cardiomyopathy. Methods MR apical hypertrophic cardiomyopathy was detected. All patients underwent echocardiography and ECG examination, of which 16 patients with radionuclide myocardial imaging, 34 patients underwent coronary and left ventricular angiography. Another 26 normal control group for comparative analysis. Results A total of 116 cases of apical hypertrophic cardiomyopathy were found, accounting for 21.2% (116/547) of hypertrophic cardiomyopathy in the same period, including 65 cases of typical apical hypertrophic cardiomyopathy (T-AHCM), 65 cases of early apical hypertrophic cardiomyopathy (P- AHCM) 51 cases. The atrial wall thicknesses in T-AHCM group and P-AHCM group were (18.6 ± 2.7) mm and (13.6 ± 1.0) mm, respectively. The ratios of apical wall thickness to basement wall thickness were 2.2 ± 0.5 and 1.6 ± 0.3, and were significantly higher than those in the normal group (9.5 ± 1.7) mm and 1.1 ± 0.1, respectively (P <0.01). The difference between the T-AHCM group and the P-AHCM group was statistically significant . The wall thickening rate in T-AHCM group was (27.7 ± 6.7)%, in P-AHCM group (41.2 ± 9.2)% and in control group (80.6 ± 6.6)%, there was significant difference between the patients and the control group (t values were 9.45 and 7.18 respectively, P <0.05). The rate of misdiagnosis in chest echocardiography was 76.9% (50/65) in T-AHCM group and 90.2% (46/51) in P-AHCM group. Conclusion MRI can diagnose apical hypertrophic cardiomyopathy accurately and is superior to echocardiography in diagnosing early-stage light-weight patients.