缩窄性心包炎磁共振成像的诊断研究

目的评价ＭＲＩ对缩窄性心包炎的诊断和鉴别诊断价值及其限度。材料与方法２６例经临床资料、心电图、Ｘ线和（或）手术证实的缩窄性心包炎患者，行心电图门控ＳＥ和ＧＥ电影ＭＲＩ扫描，ＭＲＩ所见与３０例正常成人志愿者行对比分析。结果缩窄性心包炎的主要ＭＲＩ征象有：心包脏壁层界限不清，呈不规则增厚（厚度＞４ｍｍ），以右心房室侧多见；增厚的心包呈中等信号或中等度低信号，内部信号不均，其中可有斑状极低信号或高信号；室间隔僵直，心室内径缩小，室壁运动减弱；右心房扩大，上下腔静脉扩张，少数病例左心房扩大，肺静脉扩张；可合并房室瓣少至中等量返流。结论ＭＲＩ很容易确定缩窄性心包炎的心包增厚，具有诊断和鉴别诊断的价值，但其价格昂贵、对钙化不敏感为其主要限度。

Constrictive pericarditis in magnetic resonance imaging:diagnostic study

Purpose To evaluate the diagnostic and differential diagnostic value and limitation of MRI in constrictive pericarditis (CPC). Materials and methods Twenty six patients (male 15,female 11) underwent MRI scan with ECG gated SE and GE cine techniques.The results of MRI were compared with those of normal adult volunteer's(30 cases). Results The limit between visceral and parie tal layer of the pericardium was blurring,and the thickness of the pericardium was irregularly thickening (more than 4mm). Most of them were located in the right side of the heart.The thickening pericardium demonstrated middle signal intensity,or middling low signal intensity; among them,there were spots great low signal intensity or high signal intensity.The ventricular septum became rigid,and the chamber of ventricles were smaller with hypokinesis.The enlargement of the right atrium and vena cava were seen in most cases, and the enlargement of the left atrium and pulmonary veins in few cases.The moderate to middle insufficiency of the atrium ventricular valves could be depicted in some patients. Conclusion MRI findings of CPC are characteristic by affirmation of the thickening of the pericardium, but its utility is limited because it is expensive and insensitive for calcification.