MRI评价原发性扩张型心肌病患者左、右心室功能的对照研究

Study of Magnetic Resonance Imaging in the Evaluation of Cardiac Function of Patients with Idiopathic Dilated Cardiomyopathy

目的:探讨磁共振成像技术在评价原发性扩张型心肌病(IDCM)患者左、右心室功能中的临床应用价值。方法:对42个原发性扩张型心肌病患者行磁共振检查,平均年龄(54.81±13.99)岁;纽约心脏协会(NYHA)心功分级Ⅰ～Ⅱ级者11例,Ⅲ级者16例,Ⅳ级者15例。同时选择44例志愿者作为正常对照组。采用GESign1.5T超导MR机,应用心脏专用8通道阵列线圈,采用快速稳态进动成像序列(FIESTA)行左、右室短轴电影成像,用argus软件massanalysis分别描记左、右室心内、外膜界面,自动画出左、右室容积-时间变化曲线,测得左、右心室舒张末期容积参数和功能参数,并对正常志愿者组与患者组临床资料及左、右两侧心室功能数据结果进行比较。结果:两组一般资料结果比较性别和心率差异有统计学意义;患者组与正常对照组的心功能参数差异有统计学意义(P<0.0001),患者组EF、LVPER和LVPFR比正常对照组比较减小,患者组EDV、ESV、LVEDD、LVLAD和MM与正常对照组比较扩大;IDCM组室壁增厚率明显小于正常对照组;患者组临床心功能分级与左室相关良好,与右室心功能部分参数差异有统计学意义。结论:磁共振电影成像可准确测定原发性扩张型心肌病的左、右室心功能参数,重复性好,与NYHA心功能分级有良好的相关性。

Purpose： To investigate the clinical value of magnetic resonance Imaging in evaluating right and left ventricular function of patients with Idiopathic Dilated Cardiomyopathy （IDCM）. Methods： MRI was performed in 42 （mean age 54.81 ± 13.99 years） patients with IDCM, and in 44 normal subjects as control by using a GE Sign 1.5T scanner with cine FIESTA and a phased - array body coil. According to the New York Heart Association （NYHA） criteria, the cardiac function of the patients was classified： 11 of them were class Ⅰ- Ⅱ, 16 were class Ⅲ and 15 were class Ⅳ . The images were processed using an ARGUS auto - quantitative Program. Time - volume curves of left ventricular and right ventricular were evaluated and some indexes were calculated. The study compared the data of the right and left ventricular measured by MRI between the patient group and the control group. Results： There was a significant difference between patient group and the control group in sex and heart rate. There was a significant difference between patient group and the control group in parameters of cardiac function（P 〈 0. 0001） . The values of ventricular EF, LVPER and LVPFR in patient group were smaller than those in the control group, the values of ventricular EDV, ESV、 LVEDD, LVLAD and MM in patients with IDCM were larger than those in the control group. The values of wall thickening ratio in patients with IDCM were significantly smaller than those of the control group. Conclusion： MRI is a fast comprehensive technique for the assessment of cardiac volumes and function in IDCM because of its accuracy and its high repro- ducibility. The MRI results were in correlation well with the classification of NYHA.