心室肌致密化不全的MRI表现

目的探讨磁共振对心室肌致密化不全的诊断价值。方法回顾性分析10例经心脏磁共振确诊为心肌致密化不全患者的临床及MR影像资料。结果10例患者中，男9例，女1例；除1名患者无症状之外，其余9名均有不同程度的胸闷、心悸，其中1名症状严重者出现右锁骨下静脉、上腔静脉血栓及左室心尖部血栓；心电图表现除2名患者正常之外，2名表现为心房室肥厚，6名患者表现为不同类型心律失常；所有患者中，左室心肌致密化不全3例、右室心肌致密化不全2例、双侧心室肌致密化不全5例；所有病例中心尖部均被累及，而心底部室间隔最为少见；7名患者行增强检查，其中5名出现不同范围延迟强化灶；MR电影序列舒张期较收缩期更易准确测量致密化不全心肌与致密化心肌厚度之比，TSE序列更易显示粗大肌小梁内的慢血流信号。结论心脏MR检查多序列结合多方位显示，能够准确诊断心室肌致密化不全。

MR imaging findings in noncompaction of ventricular myocardium

Objective： To investigate the clinical value of magnetic resonance imaging （MRI） in the diagnosis of noncompaction of ventricular myocardium （NVM）. Materials and Methods： We retrospectively analyzed the clinical manifestations and MRI findings of 10 NVM patients. Results： Ten patients （9 males and 1 female） presented with different clinical features. One patient was referred with no symptom, 9 patients with different degree of chest distress and palpitations, and the most serious manifestations happened in 1 adolescent with whole heart failure and thrombus in right subclavian vein, vena cava superior and left ventricular apex. Abnormal findings of electrocardiogram were found in 8 patients including hypertrophy （2 patients） and cardiac arrhythmia （6 patients）. Noncompaction myocardium involved in left ventricular in 3 patients, right ventricular in 2 patients and biventricular in 5 patients. The most frequently involved segments were apex and the least determined segment were basal-septal. The ratio of thickness of the trabecular and compact layers were more easily identified by cine sequence in diastole and the slower flow in trabecular were more easily determined by Turbo spin echo sequence. Conclusion： Noncompaction of ventricular myocardium can be diagnosed accurately with cardiac MR multiple plane and sequences imaging.