| 摘要: |
| 目的 探讨急性心肌炎在高场强3.0 T MRI影像学表现及临床意义。方法 选择临床确诊的急性心肌炎患者25例和健康志愿者15例。所有患者和健康志愿者均行 MR心脏增强扫描,扫描协议包括:双反转T2加权脂肪抑制、DWI、心脏电影、首过心肌灌注和心肌灌注延迟成像。结果 15例健康志愿者均无阳性发现。急性心肌炎组中4例(16.0%)T2加权脂肪抑制显示左心室心肌表现为局灶性斑点或斑片状高信号；6例(24.0%)心脏DWI出现局灶性高信号；4例(16.0%)心脏电影出现局部室壁运动异常,表现为室壁运动轻度减弱,测得25例患者的左心室射血分数、左心室舒张末期容积及左心室舒张末期直径分别为(58.9±4.7)%、(147.0±28.9) mL、(51.8±4.7) mm,3个参数与健康者差异无统计学意义(P>0.05)；1例(4.0%)首过心肌灌注表现为局部心肌灌注减低；23例(92.0%)出现心肌延迟强化,表现为左心室心外膜下和(或)中层心肌结节状、片状强化,共计53个节段,发生部位以间隔壁和侧壁居多。室壁运动异常区域与延迟强化节段一致。结论 3.0 T心脏MR检查可以显示急性心肌炎的病变部位、形态、范围、程度及心功能情况,综合分析心脏MR各个序列的结果,可以为急性心肌炎的诊断与鉴别诊断提供影像学依据。 |
| 关键词: 心肌炎 磁共振成像 诊断 |
| DOI：10.3724/SP.J.1008.2013.00541 |
| 投稿时间：2013-03-01修订日期：2013-03-28 |
| 基金项目: |
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| 3.0 T cardiac MRI of acute myocarditis and its clinical significance |
| LIANG Ting,SHAO Zhi-hong,NI Jiong,XU Wei-guo,DAI Gong-hua,WANG Pei-jun* |
(Department of Medical Imaging, Tongji Hospital, Medical School of Tongji University, Shanghai 200065, China
*Corresponding author.) |
| Abstract: |
| Objective To investigate the appearance of 3.0 T magnetic resonance imaging (MRI) of acute myocarditis (AM) and the related clinical significance. Methods A total of 25 patients with AM were assigned to myocarditis group and 15 healthy volunteers were assigned to control group, all cases underwent cardiac MRI enhancement. The protocol included dual inversion recovery T2-weight null fat, diffusion weight imaging (DWI), cine, first-pass perfusion and delayed enhancement MRI. Results No positive abnormality was found in the 15 healthy volunteers. In the myocarditis group, 4 (16.0%) cases showed focal spot or patchy high signal in the left ventricular (LV) myocardium in dual inversion recovery T2-weight null fat. DWI in LV myocardium showed hyperintensity in 6 (24.0%) cases. Cine revealed reduced local ventricular wall motion in 4 (16.0%) patients. The ejection fraction (EF), LV end-diastolic volume and LV end-diastolic diameter in the 25 AM patients were(58.9±4.7)%, (147.0±28.9) mL, and (51.8±4.7) mm, respectively, which were not significantly different from those of the control group (P>0.05). One (4.0%) case had reduced local myocardial perfusion during first-pass perfusion. A total of 53 myocardial segments were involved in the 23 (92.0%) cases with subepicardial or/and mid-myocardial delayed enhancement, which mainly located in the septal zone and lateral zone. Ventricular wall motion abnormalities were consistent with delayed enhanced segments. Conclusion 3.0 T MRI can display the position, shape, range, degree and function of AM. Comprehensive analysis of cardiac MR sequences can provide imaging evidence for diagnosis and differential diagnosis of AM. |
| Key words: myocarditis magnetic resonance imaging diagnosis |
