MRI延迟强化在肥厚型心肌病中的临床意义

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1、万方数据·396·虫垡丝盟堂苤壶!!!!笙!旦笙!!鲞箜!塑竺!i!』堕塑型!丛!∑!!!!!!!!．!!!!!·!MRI延迟强化在肥厚型心肌病中的临床意义吕传剑赵世华陆敏杰蒋世良赵涛陈秀玉马宁尹刚史大鹏．胸部放射学．【摘要】目的回顾性分析肥厚型心肌病(HCM)左心室心肌肥厚MRI延迟强化与临床特征的关系。方法收集79例HCM患者行MR检查，先常规实施心脏结构和功能检查，再进行钆对比剂延迟强化(LGE)扫描。按17节段法，分别测量心肌厚度、射血分数、左心室舒张期末容积等，并进行LGE评分。性别、胸闷等组问LGE的差异采用卡方检验，临床特征与测得数据采

2、用Logisti(’回归分析，并以分析卅阳性症状为参考标准评价LGE预测心脏事件的准确性，比较ROC曲线下面积。结果79例患者共计1343节段，其中肥厚节段633个，基底段前室间隔(第2节段)肥厚节段数最多(64个)，其次为第9、3和8节段，分别为58、57和57个。LGE显示受累节段433个，第2节段最多(51个)，其次为第8、9和14节段，分别为39、37和36个。左心房前后直径、LGE是心房颤动的独立预测因子(HR分别为1．11和1．12，P≤0．01)，ROC曲线下面积分别为0．726、0．743；LGE是非持续性室性心律失常(NSVT)的独

3、立预测因子(HR=1．15，P≤0．01)，ROC曲线下面积为0．817。结论HCM患者心肌肥厚及LGE呈不对称性分布，LGE是HCM发生NSVT及心房颤动的独立危险因素。【关键词】肥厚型心肌病；心律失常；磁共振成像LategadoliniumenhancementMRIinpatientswithhypertrophiccardiomyopathyLgChuan-jian’．ZHAOShi．hua．LUMin-jie，JIANGShi—liang．zHAt)Tao，CHENXiu—yu，MANing，YlNGang．sHIDa-peng．Depar

4、tmentofRadiology，FuwaiHospital，StateKeyixtborator)。oj‘CardiovascularDisease．NationafCenterforCardiovascularDiseases．C^ineseAcadem)ofMedicazSciencesandPekingUnionMedicalCollege，Beijing』00∞7，China4(Presentaddress：DepartmentofRadioligy，HenanProvincialPeople’SHospita2．Zhengzhou4500

5、03．C^ina)Correspondingauthor：ZHA0Shi．hua，Email：c{r’zhaoshihua@rip．163．corn【Abstract】objectiveToretrospectivelyanalyzethecorrelationoflategadolinimnenhancement(LGE1onMRlwiththeextentofhypertrophicleftventricularmyoeardiumandclinicalfeaturesinhypertrophiccardiomyopathy．MethodsSev

6、enty—ninepatientswithhypertrophiccardiomyopathywereincludedinthisstudy．RoutineandfunctionalcardiacMRIscanswereperformed，all(1thenallpatientsunderwentlategadoliniumenhancement(LGE)MRI．Thethi(·knessofmyocar(1ium，ventricnlarfunctionincludingejectionfraction(EF)andlefcventrieularen

7、ddiastolicvolufne(LVEDV)accordingtothetraditional17-sectionalmethodweremeasuredandtheLGEscorewascalculated．TheChi—squaretestandLogisticregressionanalysiswereusedtoassesstheaccuracyofLGEpredictingcardiaceventsandtheareaunderROCcurvewascompared．ResultsAtotalof1343segmentsincludin

8、g633hypertrophicsegmentsin79patientswereenrolledforthe