心内膜心肌纤维化症的影像诊断

目的　探讨心内膜心肌纤维化症 (EMF)的影像诊断价值。方法　回顾分析 2 8例EMF影像学表现。结果　右室型 2 1例 ,左室型 1例 ,双室型 6例。平片对本病误诊率较高 ,误诊为 18/ 2 8例 ;造影及MRI均能显示右心型右室流入道变小、缩短 ,边缘不整 ,心尖闭塞 ,流出道扩张 ,三尖瓣大量返流 ,右房巨大 ,上腔静脉扩张。左室型表现为左室流出道狭窄、边缘不规则 ,室腔变形变小 ,收缩与舒张期无明显变化 ,心尖圆钝 ,二尖瓣返流。双室型表现为左右室型的特点 ,但以右室型表现为主。结论　X线平片对本病的诊断价值有限 ,造影及MRI检查均能确诊本病 ,而MRI为无创安全的检查可取代造影成为首选检查方法

Imaging Diagnosis of Endomyocardial Fibrosis

Objective To investigate the value of imaging diagnosis of endomyocardial fibrosis(EMF).Methods Imaging findings of 28 cases of EMF were restrospectively analyzed.Results There were three types:right ventricle type(n=21),left ventricle type(n=1),and dual ventricle type(n=6).The misdiagnostic rate of EMF by X-ray plain films was high(18/28). On angiography and MRI right ventricle type presented as shortened,deformed inflow-tract,obliteration of apex and dilated outflow-tract,marked tricuspid valve regurgitation(TR) and enlarged right atrium,even dilated superior vena cava,left ventricle type presented as narrowiug and deformed inflow-tract,small and deformed left ventride,even no markedly volume changes in relaxation or contraction,obtuse cardiac apex and mitral regurgitation.Dual ventricle type owned manifestations in the two types mentioned above,but predominated by right ventricle type. Conclusion In diagnosis of EMF X-ray plain films are of less value while MRI and cardioangiography are significant,MRI is a valuable non-invasive method,it can substitutd for cardioangiography as the first choice in diagnosing EMF.