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探讨心脏磁共振成像在致心律失常心肌病诊断中的应用价值

苏 莲子, 许 玲

摘要

目的回顾性分析致心律失常心肌病的心脏磁共振成像(CMR)表现,探讨CMR在其诊断中的应用价值。方法搜集2020年7月-2023年6月在我院行CMR检查并诊断为致心率失常心肌病患者20例。从心脏形态结构(心肌脂肪浸润、房室大小)、功能(室壁运动)、心肌组织学特性等方面对心室受累程度进行分析。结果20例患者,双室受累9例,单纯右室受累6例,单纯左室受累5例。双室受累组9例中,均表现为右室流出道增宽、左右室壁变薄、左右室壁收缩运动减低,7例左室腔扩大,出现右室壁心肌脂肪浸润、延迟强化均为5例,左室壁心肌脂肪浸润、延迟强化均为7例;单纯右室受累组6例均表现为右室流出道扩张,右室腔扩大及室壁收缩运动减低,2例右室壁心肌脂肪浸润,4例表现为右室壁与心外膜脂肪分界不清;单纯左室受累组均表现为左室壁变薄或偏薄、不同程度左室壁或室间隔脂肪浸润及延迟强化,4例左室腔扩大。结论CMR检查在致心率失常性心肌病诊断中具有重要应用价值,能较好评估心室受累情况。左心室是否受累不能用于ARVC病程判断,右心室受累ARVC患者主要表现为右心室腔扩大、室壁变薄及不同程度右室流出道扩张,而左心室受累ARVC主要表现为特征性左心室心肌脂肪浸润及延迟强化。

关键词

心肌疾病;心律失常;磁共振成像.

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参考

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