MR心肌延迟增强扫描在常见非缺血性心脏病中初步应用

目的研究常见非缺血性心脏病患者心肌病变的磁共振心肌延迟强化的影像学特征。方法回顾性分析25例非缺血性心脏病患者的磁共振心肌延迟强化特点及相应临床表现。结果 25例患者中9例患者心肌病变未出现延迟强化。6例为病毒性心肌炎,4例出现左室后壁、下壁心外膜下心肌可见斑片状延迟强化,1例室间隔部出现散在线状强化;6例为肥厚性心肌病,4例出现室间隔及左室壁出现延迟强化,表现为片状强化;12例为扩张性心肌病,4例在左心室间隔壁、侧壁可见线样强化,左室后下壁、前间隔壁各1例可见小片状强化,以心肌中层及外膜下心肌为主。1例为致心律失常型右室心肌病,延迟强化提示右室下壁及前壁可见片状强化。结论非缺血性心脏病患者心肌病变的磁共振心肌延迟强化具有一定特征,鉴别非缺血性心脏病的病因有赖于密切结合临床病史。

Preliminary application of magnetic resonance myocardial delayed enhancement in nonischemic myocardial diseases

Objective To study the imaging characteristics of magnetic resonance myocardial delayed enhancement in nonis- chemic myocardial diseases. Methods The imaging and clinical characteristics of magnetic resonance myocardial delayed en- hancement in 25 patients with nonischemic myocardial diseases were retrospectively analyzed. Results Among the 25 cases, there was no magnetic resonance myocardial delayed enhancement in 9 patients with nonischemic myocardial diseases. Six cases were viral myocarditis, 4 of which showed patchy delayed enhancement at the inferior and posterior wall of the left ventricle in ep- icardium, 1 of which showed scattered linear delayed enhancement in the septum; 6 cases were hypertrophic cardiomyopathy, patchy delayed myocardial enhancement was shown in the left ventricular wall and septum in 4 patients; 12 cases were dilated cardiomyopathy, 4 of which showed stripy delayed myocardial enhancement in the septum and lateral wall of the left ventricle, 2 of which showed patchy enhancement in the area of epicardium and midwall of basal inferior and apical septal wall of the left ven- tricle; 1 case was arrhythmogenic right ventricular dysplasia （ ARVD）, in which patchy enhancement was shown in the inferior and anterior wall of the right ventricle. Conclusion There are some imaging characteristics of magnetic resonance myocardial delayed enhancement in nonischemic myocardial diseases, the differentiation of etiology of delayed enhancement relies upon both MR images and clinical history.