64层螺旋CT冠状动脉成像对左心室心肌密度差异的分析

目的 分析64层螺旋CT(MSCT)冠状动脉CT血管成像(CTA)检查中,左心室心肌密度的特征性差异.方法 行64层MSCT冠状动脉CTA检查的连续病例1130例中冠状动脉正常或狭窄程度＜25%的患者共119例.回顾性分析其CT增强扫描重建层厚3mm的横断面图像,选取主动脉瓣下缘平面左心室心肌为测量评价目标,在室间隔后部、前部、心尖、左心室游离壁前部及游离壁后部划5个兴趣区,分别测量其平均CT值,用配对t检验统计方法比较其差异.结果 主动脉瓣下横断面图像中正常人左心室心肌密度值:室间隔后部、前部分别为(93.8±14.8)和(91.9±15.1)HU,心尖部为(69.9±15.5)HU,左心室侧壁前部、后部平均CT值分别为(79.7±16.9)和(88.0±14.3)HU,平均密度呈现为"U"字型.上述5个测量部位中,室间隔前部、后部测量值之间差异无统计学意义(t=0.968,P=0.3339),室间隔前部与心尖部、心尖部与左心室游离壁前部心肌密度差异具有统计学意义(t值分别为11.060和4.639,P值均＜0.01).结论 冠状动脉CTA检查中左心室心肌密度有差异,以心尖部最低,因此,依靠心肌低密度判断心肌梗死时要引起注意.     

核素心肌断层显像诊断心尖肥厚型心肌病

目的　探讨核素心肌断层显像对心尖肥厚型心肌病 (AHCM)的诊断价值。方法　 32例有特殊心电图改变、疑为AHCM的患者行超声心动图 (UCG)、99Tcm 甲氧基异丁基异腈 (MIBI)心肌断层显像、冠状动脉造影及左室造影等检查。结果　 32例患者中确诊为AHCM者 2 9例 ,UCG与核素心肌断层显像诊断灵敏度分别为 93.1%和 89.7% ,两者差异无显著性 (P >0 .0 5 )。结论　99Tcm MIBI心肌断层显像是诊断AHCM一种有效无创的方法。     

MSCT在左心室功能及冠脉主干径线测定中的应用价值

目的：探讨MSCT成像技术在左心室功能及冠脉径线测量中的应用价值。方法：对28例临床拟诊冠心病的患者进行回顾性心电门控MSCT心脏扫描，分别对左心室容积、室壁厚度、射血分数和室壁收缩增厚率及左、右冠脉主支内径进行测量，MSCT测得结果与超声心动图和数字减影冠脉造影进行对比。结果：MSCT测得的左心室舒张末期容量(EDV)、收缩末期容量(ESV)、射血分数(EV)、心肌收缩末期厚度(EST)、心肌舒张末期厚度(EDT)及室壁增厚率与超声心动图相关性较好，测量结果MSCT略小于超声心动图，但两者相比无显著性差异。MSCT与数字减影冠脉造影左、右冠脉主支内径的测量值间无显著性差异。结论：MSCT在左心室功能及冠脉主干径线测定中具有很高的临床应用价值。     

左心室及冠状动脉造影诊断心尖肥厚型心肌病

目的:探讨左心室及冠状动脉造影诊断心尖肥厚型心肌病的价值.材料和方法:147例心电图异常患者,行UCG,冠状动脉及左心室造影,21患者进一步行MRI检查确诊为心尖肥厚型心肌病.结果:147例中, UCG发现67例心尖部肥厚.左心室造影示126例左心室舒张期形态均呈"黑桃"样改变,诊断阳性率85.7%.冠状动脉造影示19例冠状动脉有狭窄.结论:左心室及冠状动脉造影是诊断心尖肥厚型心肌病较好的方法,并能了解冠状动脉病变情况.     

双源CTA评价非ST段抬高型急性冠脉综合征

目的:探讨双源CT血管成像(DSCTA)评价非ST段抬高型急性冠脉综合征(NSTE-ACS)的价值.方法:搜集临床疑似NSTE ASC且经DSCTA判断为左冠状动脉前降支管腔临界狭窄(狭窄程度为50％～70％)的患者57例,1周内行冠脉造影(CAG)证实狭窄程度,并行导管法测量血流储备分数(FFR),以FFR 0.80为临界值将57例患者分为A组(FFR＜0.80)和B组(FFR≥0.80),测量左室前壁、侧壁心肌、左心室腔CT值及舒张末期、收缩末期节段室壁厚度,比较两组间前壁与侧壁相对CT值、舒张末期心肌厚度及室壁增厚率.结果:A、B两组前壁与侧壁心肌相对CT值及舒张末期心肌厚度差异均有统计学意义(P＜0.05),A组前壁与侧壁室壁增厚率差异有统计学意义(P＜0.05),B组前壁与侧壁室壁增厚率差异无统计学意义(P＞0.05);前壁心肌相对CT值及室壁增厚率A、B两组间差异有统计学意义(P＜0.05),而舒张末期心肌厚度A、B两组间差异无统计学意义(P＞0.05).结论:DSCTA评价左冠状动脉前降支管腔临界狭窄联合节段心肌CT值、舒张末期心肌厚度及室壁增厚率分析,可为NSTE-ACS的诊断及治疗提供依据.     

左室扭转运动参数Ptw、AVCtw、MVOtw、UntwR联合检测鉴别诊断梗阻性心尖肥厚型心肌病的价值

目的 探讨左室扭转运动参数扭转角度峰值(Ptw)、收缩期末扭转角度(AVCtw)、等容舒张期末扭转角度(MVOtw)、解旋率(UntwR)联合检测鉴别诊断梗阻性肥心尖厚型心肌病(AHCM)的价值。方法 选取中国人民解放军联勤保障部队第九八八医院在2021年03月～2023年03月期间接收的143例AHCM患者作为AHCM组,另选同期健康体检者100例作为健康对照组,入院后均行二维超声心动图检查,比较两组入院时常规超声心动图参数[室间隔的舒张末期厚度(IVSD)、左室后壁的舒张末期厚度(LVPWD)、左室收缩末期的容积(LVESV)、左室舒张末期的容积(LVEDV)];比较两组入院时二维斑点追踪显像(2D-STI)检查的左心室扭转运动参数Ptw、AVCtw、MVOtw、UntwR;分析左心室扭转运动参数Ptw、AVCtw、MVOtw、UntwR与常规超声心动图参数IVSD、LVPWD、LVESV、LVEDV、LVEF相关性;比较梗阻性、非梗阻性AHCM患者左心室扭转运动参数Ptw、AVCtw、MVOtw、UntwR;分析左心室扭转运动参数Ptw、AVCtw、MVOtw、UntwR联合检测...     

斑点追踪技术评价冠状动脉慢血流患者左心室纵向收缩功能

目的探讨二维斑点追踪技术(2D-STE)评价平板运动负荷前后冠状动脉慢血流(Coronary slow flow,CSF)患者左心室纵向收缩功能的变化,为临床提供可靠的信息。方法选取临床诊断CSF患者33例(CSF组)及冠状动脉造影检查结果正常者30例(对照组),分别在静息状态和运动负荷后,采集左心室长轴、心尖四腔及心尖两腔动态二维图像,计算两组左心室收缩末期的内径(LVEDS)、左心室舒张末期的内径(LVEDD),左心室舒张末期的容积(LVEDV)、左心室射血分数(LVEF)、左心室整体纵向应变(GSL)及负荷前后GLS变化幅度(ΔGLS)。结果静息状态下:两组LVEDD、LVESD、LVEDV、LVEF差异均无统计学意义(P>0.05),两组GLS差异有统计学意义(P<0.001);两组负荷LVEF均较静息状态下明显升高(P<0.01),但是两组间比较差异无统计学意义(P>0.05);两组的负荷GLS均较静息状态明显升高,且两组间差异有统计学意义(P<0.01),对照组的静息状态下及负荷峰值状态下左心室GLS均大于CSF组。结论静息状态下,CSF患者左心室纵向收缩功能减低;运动负荷状态下,CSF患者左心室纵向收缩显著改善;左心室心肌纵向应变值GLS能早期识别CSF患者的心肌纵向收缩功能的细微变化,为临床提供可靠的诊疗价值。     

心肌声学造影和二维斑点追踪成像在冠心病诊断中的应用价值

目的 分析对比冠心病患者的心肌声学造影(MCE)、二维斑点追踪成像技术(2D-STI)与冠状动脉血管造影术的结果，评价左心室心肌声学造影及2D-STI在冠心病节段室壁血流灌注异常中的应用价值。方法 选取本院50例临床初诊为冠心病患者的心肌声学造影及2D-STI,将其分别与冠状动脉造影结果进行对照分析，评估其在室壁节段血流灌注异常的准确性与一致性。结果 50例冠心病患者经冠状动脉造影纳入血管共150支，其中40例患者经冠状动脉造影证实有单支或多支冠状动脉狭窄>50%,病变血管56支，左前降支30支，左旋支12支，右冠状动脉14支。单支病变22例，多支病变18例，冠状动脉造影正常10例。按照冠状动脉的供血范围与左心室壁17节段相对应关系入选的心肌节段共850个，冠状动脉狭窄0%～49%的心肌节段共672个，冠状动脉狭窄50%～75%的心肌节段共65个，冠状动脉狭窄76%～99%的心肌节段共103个，冠状动脉完全闭塞的心肌节段10个。MCE检出心肌灌注异常与冠状动脉狭窄≥50%的一致性为89%,2D-STI检出节段室壁运动异常与相应供血支冠状动脉狭窄≥50%的一致性为87%;以冠状动脉...     

超声心动图联合心电图检查对心尖肥厚型心肌病病情及定位评估效果

目的探讨心电图(ECG)联合超声心动图检查对心尖肥厚型心肌病(AHCM)病情程度及定位的评估效果。方法选取山东大学附属省立医院2016年1—12月收治的38例AHCM患者纳入观察组,同期选取我院体检的38例健康成人纳入健康组。对所有受试对象均行心电图联合超声心动图检查,比较两组受试对象的心电检测异常情况、5项心肌肥厚指标情况(SV1+RV5、RV2+SV1、RV3+SV1、SV3+Ra VL、ΣQRS)以及7项超声心动图指标[左房内径(LAD)、室间隔厚度(IVS)、左心室后壁厚度(LVPW)、左心室收缩末期内径(LVDs)、左心室舒张末期内径(LVDd)、左心室缩短分数(LVFS)、左心室射血分数(LVEF)],并分析心肌肥厚指标与超声心动图指标的相关性。结果心电图分析显示,观察组心电异常指标和心肌肥厚指标均明显高于健康组。超声心动图分析显示,观察组患者LAD、IVS及LVPW均明显高于健康组,差异均有统计学意义(P<0.05),符合AHCM患者的诊断。采用简单散点图对心肌肥厚指标与超声心动图检查指标进行线性拟合,对考虑线性相关变量行Pearson双变量相关性分析显示,∑QRS、RV2+SV1、RV3+SV1与IVS呈正相关;∑QRS、RV2+SV1、RV3+SV1与LAD呈正相关;RV2+SV1、RV3+SV1与LVDd正相关,且相关性较强。结论心电图联合超声心动图检查能有效评估AHCM的病情,准确定位肥厚部位。     

Effect of Coronary Artery Stenosis on the Transmural Extent of the Rest Myocardial Perfusion of Different Segments of Left Ventricular Wall Using 640 Slices CT

目的 确定静息态下透壁心肌灌注指数(TPR)的正常值,并探讨静息态下不同分支的冠状动脉狭窄与各冠状动脉分支的不同狭窄程度对左室壁不同节段TPR的影响.方法 274例患者行Toshiba 640层CT检查,包括冠状动脉CTA及左心室室壁CT灌注(CTP)检查.根据冠状动脉狭窄程度及17节段进行分组.计算正常组及不同冠状动脉狭窄程度组之间相应节段内TPR是否存在差异,以及冠状动脉狭窄程度与相应节段TPR的相关性.结果 前降支及左旋支病变对于左室壁心肌灌注影响较为明显,前降支狭窄主要影响中间段前壁(r=-0.288)、心尖段前壁(r=-0.263)及中间段间隔壁(r=-0.196),左旋支主要影响基底部前侧壁(r=-0.241)、基底部后侧壁(r=-0.279)及心尖段侧壁(r=-0.201),而右冠状动脉病变影响较小,主要影响中间段后壁(r=-0.195);冠状动脉中、重度狭窄组对于左室壁心肌灌注影响程度较大(P＜0.05),轻度狭窄影响较小;左室前壁心肌灌注最易受到冠状动脉狭窄影响;在静息状态下前降支供血区域组、左旋支供血区域组及右冠状动脉供血区域组正常心肌和重度狭窄心肌平均TPR值分别为1.14±0.09和1.07±0.13、1.13±0.11和1.06±0.14、1.15±0.14和1.10±0.12.结论 不同冠状动脉分支狭窄分别可以影响不同节段的心肌透壁灌注;不同冠状动脉狭窄程度可以不同程度地影响心肌的TPR,二者具有相关性;静息状态下TPR正常值大于负荷状态下TPR.本研究提供了TPR静息态下的正常值.     

动脉导管未闭手术前后左室功能的对比

应用超声心动图测量儿童和成人各３６例动脉导管未闭患者．（ＰＤＡ）在手术前后左室舒张末期内径和收缩末期内径。应用Ｃｕｂｅ公式自动计算出左室舒张末期容积,收缩末期容积、每搏搏出量、射血分数、和短轴缩短率。将手术前后两组测量数据分别用统计学配对ｔ检验,再对两组手术前后ＬＶＥＤＶ指数进行对比。结果表明,两组手术后ＬＶＥＤＤ、ＬＶＥＤＶ、ＬＶＥＳＶ、ＬＶＳＶ、ＬＶＥＦ和ＬＶＦＳ均有不同程度变化,两者差异显著     

多层螺旋CT与M型超声心动图评估左室功能的对照研究

目的：用多层螺旋CT（multi-detector row computed tomography,MRCT）测量并评估左室功能的各项参数,并与M型超声心动图测量得到的结果进行比较。方法：62位冠心病或可疑患有冠心病的患者（男性40人、女性22人,平均年龄64.2±11.1岁）在24h内接受回顾性心电门控16通道MRCT心脏增强扫描及心脏M型超声心动图检查。在GEAW4.1CT工作站上测量出每位患者的左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）并根据公式（LVEDV-LVESV）/LVEDV×100%计算出左室射血分数（LVEF）,并用简单直线回归分别分析MRCT测量所得参数与M型超声心动图测得结果的相关性。结果：16层CT测得的LVEDV为125.4±62.1ml、LVESV为52.8±59.3ml、LVEF为62.9±13.4%,与M型超声心动图测量结果（Teichholz校正公式法）有很好的相关性〔LVEDV为112.8±49.7ml（r=0.826,P〈0.001）、LVESV为45.9±47.0ml（r=0.960,P〈0.001）、LVEF为64.8±13.9%（r=0.916,P〈O．001）]。结论：回顾性心电门控MRCT心脏增强扫描可以应用于临床心功能的评估诊断。     

Assessment of global and regional left ventricular function and volumes with 64-slice MSCT: A comparison with 2D echocardiography

Background  In patients with coronary artery disease (CAD), LV function and volumes are important parameters for long-term prognosis. Multislice computed tomography (MSCT) allows noninvasive assessment of the coronary arteries, but the accuracy of 64-slice MSCT for the assessment of left ventricular (LV) volumes and function is unknown. Methods and Results  A head-to-head comparison between 64-slice MSCT and 2-dimensional (2D) echocardiography was performed in 40 patients with known or suspected CAD. The LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were determined and the LV ejection fraction (LVEF) was derived. Regional wall motion was assessed visually using a 17-segment model. A 3-point scoring system was used to assign to each segment a wall motion score: 1 = normokinesia, 2 = hypokinesia, 3 = akinesia or dyskinesia. Two-dimensional echocardiography served as the gold standard. MSCT agreed well with 2D echocardiography for assessment of LVEDV (r = 0.97; p < .0001) and LVESV (r = 0.98; p < .0001). An excellent correlation between MSCT and 2D echocardiography was shown for the evaluation of LVEF (r = 0.91; p < .0001). Agreement for the assessment of regional wall motion was excellent (96%, κ = 0.82). Conclusions  An accurate assessment of global and regional LV function and volumes is feasible with 64-slice MSCT. This work was supported by The Netherlands Heart Foundation, The Hague, The Netherlands, grant numbers 2002B105 (J.D.S.) and 2001D032 (J.W.J.).     

Global and regional left ventricular function: a comparison between gated SPECT, 2D echocardiography and multi-slice computed tomography

Purpose Global and regional left ventricular (LV) function are important indicators of the cardiac status in patients with coronary artery disease (CAD). Therapy and prognosis are to a large extent dependent on LV function. Multi-slice computed tomography (MSCT) has already earned its place as an imaging modality for non-invasive assessment of the coronary arteries, but since retrospective gating to the patient’s ECG is performed, information on LV function can be derived. Methods In 49 patients with known or suspected CAD, coronary angiography with MSCT imaging was performed, in addition to gated SPECT and 2D echocardiography. LV end-diastolic and LV end-systolic volumes and LV ejection fraction were analysed with dedicated software (CMR Analytical Software System, Medis, Leiden, The Netherlands for MSCT; gated SPECT by QGS, Cedars-Sinai Medical Center, Los Angeles, CA, USA), and by the biplane Simpson’s rule for 2D echocardiography. Regional wall motion was evaluated according to a 17-segment model and a three-point score system. Results Correlations were fairly good between gated SPECT and MSCT (LVEDV: r=0.65; LVESV: r=0.63; LVEF: r=0.60), and excellent between 2D echocardiography and MSCT (LVEDV: r=0.92; LVESV: r=0.93; LVEF: r=0.80). Agreement for regional wall motion was 95% (κ=0.66) between gated SPECT and MSCT, and 96% (κ=0.73) between 2D echocardiography and MSCT. Conclusion Global and regional LV function and LV volumes can be adequately assessed with MSCT. Correlations with 2D echocardiography are stronger than with gated SPECT.     

Incidental spade-shaped FDG uptake in the left ventricular apex suggests apical hypertrophic cardiomyopathy

Purpose

Apical wall thickening with an “ace-of-spades” configuration is a unique sign of apical hypertrophic cardiomyopathy (AHCM). We investigated spade-shaped FDG uptake around the left ventricular apex (SSUA) incidentally found in routine oncological FDG PET.

Methods

Cases showing SSUA were selected based on retrospective review. The pattern or intensity of SSUA was compared with the results of electrocardiogram (ECG), echocardiography, and stress myocardial perfusion SPECT. The diagnosis of ACHM was based on the presence of giant negative T wave in ECG, thickness of spade-shaped hypertrophy in the apex in echocardiography, and increased tracer uptake in the apex in rest SPECT.

Results

Among the 34 patients in 36 PET scans showing SSUA, SSUA was weak in 17 and intense in 17. There were isolated SSUA (n?=?29) and SSUA with diffuse or other focal left ventricular uptake (n?=?5). Three patients with the latter uptake pattern turned out to have coexistence of AHCM and asymmetric septal hypertrophy. Of the 16 SSUA-positive patients who underwent echocardiography, 13 (81%) were diagnosed as AHCM and the remaining 3 were regarded as borderline AHCM (apical wall thickness, 14–15 mm). There were 16 patients with SSUA who also underwent PET scans after the study period among which 11 (69%) had persistent SSUA in the follow-up PET. In the remaining 5, follow-up PET scans showed diffuse left ventricular uptake and SSUA was barely visible. The intensity of SSUA was significantly or marginally associated with giant negative T wave (p?<?0.01), apical asynergy (p?=?0.08), and impaired coronary flow reserve (p?<?0.05). There were no other factors correlated with the pattern or intensity of SSUA.

Conclusion

SSUA incidentally found in oncological FDG PET appeared to be associated with AHCM, especially in ischemic conditions. The moderate repeatability of SSUA was probably due to obscurity by physiological uptake.

     

三平面组织同步成像定量评价冠心病患者左心室节段非同步运动

目的 探讨三平面组织同步成像技术定量评价冠心病患者左心室节段收缩非同步性运动及其与左心室收缩功能的关系.资料与方法 34例冠心病患者和35例正常对照者,应用三平面组织同步成像技术获得心尖四腔切面组织速度图,获取左心室6个壁共12个节段的收缩期达峰时间(Tp)、达峰速度(Vp),并计算Tp、Vp的标准差(Tp-SD、Vp-SD)及12个节段中任意2个节段Tp、Vp的最大差值( Tp-maxD、Vp-maxD).同时采用Simpson双平面法测量左室射血分数(LVEF)、左室舒张末期容积(LVESV)、左室收缩末期容积(LVEDV).结果 冠心病组LVEDV、LVESV较正常对照组增加,LVEF较正常对照组减小,差异均有统计学意义(P＜ 0.001).与正常对照组相比,冠心病组Tp、Tp-SD、Tp-maxD均明显延迟,Vp、Vp-SD、Vp-maxD均明显降低(P＜0.001);Tp与LVEF呈负相关(r=-0.559,P＜0.001);Vp与LVEF呈正相关(r=0.801,P＜ 0.001).结论 三平面组织同步成像可用于定量评价冠心病患者左心室非同步运动,Tp、Tp-SD、Tp-maxD、Vp、Vp-SD、Vp-maxD 可作为定量评价左室收缩运动同步性的有效指标,且左室运动同步性异常加重左室收缩功能异常.     

Angiocardiographic evaluation of left ventricular volumes and wall motion in infants and children: determination of normal values and analysis in diseased hearts

Normal values of left ventricular (LV) function were determined angiographically in 50 normal infants and children. With these normal control data, LV function was assessed in 44 patients with a variety of cardiac diseases. LV volumes were calculated from 30 degrees right anterior oblique cineangiograms using area-length method. Normal values for LV end-diastolic volume (LVEDV) was expressed as a function of body surface area (BSA): LVEDV = 72.4 (BSA). The ratio of measured value to predicted normal value was calculated in the evaluation of diseased hearts. Mean LV ejection fraction (LVEF) in the normal group was 58.9 +/- 5.7%. There was no apparent correlation between LVEF and BSA or age of the patients. For the objective analysis of regional wall motion, the most adequate method was Area method which divides left ventriculogram into 5 regions. Mean ejection change in each region in the normal group was as follows; segment 1 (anterobasal) 52.4 +/- 6.9 (SD)%, segment 2 (anterolateral) 42.6 +/- 7.8%, segment 3 (apical) 46.3 +/- 6.7%, segment 4 (diaphragmatic) 37.0 +/- 7.0% and segment 5 (posterobasal) 29.0 +/- 5.6%. In the group of congenital heart disease with L-R shunt, 16 of 20 patients showed apparent increase of LVEDV. It remained within the normal range in 3 patients who had small shunt. There was no case which showed decreased LVEF or impaired regional wall motion. Both of the 2 patients with congestive cardiomyopathy showed increased LVEDV and decreased LVEF. Generalized hypokinesis of LV was recognized in one of them. In the group of Kawasaki disease with abnormal coronary arteries, which consisted of 27 ventriculograms in 22 patients, increased LVEDV and decreased LVEF were recognized in patients with coronary artery occlusion or large aneurysm. Decreased wall motion was observed in the territories of abnormal coronary arteries presenting occlusion or large-to-medium-sized aneurysm.     

基于64层CT的左冠状动脉前降支动脉硬化程度与左心功能改变相关性研究

目的：利用64层CT对左冠状动脉前降支动脉硬化与左心功能变化之间的相关性进行评估.方法：经64层CT确诊的左冠状动脉前降支（LAD）硬化狭窄共83例,正常对照组20例,均行64层螺旋CT心功能分析,分别计算出左室心肌质量、左室射血分数、左室舒张末期容积、左室收缩末期容积和每搏输出量等参数.按前降支管腔狭窄程度（〈50%,50%～70%,〉75%）对研究对象进行分组,并进行统计学分析.结果：A组（管腔狭窄〈50%）21例,心功能参数无显著变化;B组（管腔狭窄50%～75%）33例,主要表现为左室心肌质量增加,左室收缩末期容积增加,射血分数减小;C组（管腔狭窄〉75%）29例,可见LAD多发软斑块或混合性宽块,左心室心功能明显减低.结论：随着左冠状动脉前降支狭窄程度加重,心功能经历代偿到失代偿动态过程,64层CT在评价冠状动脉粥样硬化狭窄程度与心功能相关性方面具有重要价值.     

彩色多普勒与其它检查方法对心尖肥厚型心肌病诊断价值的比较

目的 :探讨CDFI对AHCM的诊断价值。材料和方法 :对经ECG、MRI、CIN和EMB检查确诊的AHCM的CD FI特点与诊断及鉴别诊断方法进行分析、讨论。结果 :分别由上述检测技术提示或证实的 2 1例AHCM患者均显示乳头肌以下心室游离壁 /室间隔不同程度的增厚。当厚度 >1 5cm以上者 ,心室收缩时 ,室腔区可消失。 2 1例中有 2例合并有右室心尖肥厚。结论 :CDFI为AHCM最理想的检测方法。如结合以上其它检查 ,特别是ECG提示 ,则可避免假阴性的出现 ,进一步提高准确性