心包隐窝的MRI所见与解剖对照研究

Recesses of the Pericardium: A Comparison between MR Imaging and Sectional Anatomy

目的: 熟悉正常心包隐窝的MRI 表现,对诊断与鉴别诊断具有重要的临床应用价值。材料与方法: 选用胸部断层解剖标本4 例,心包完整离体心脏标本2 例。搜集经MRI 检查无心包病变患者图像21 例。结合解剖,分析MRI 上正常心包各隐窝的形态、位置、毗邻关系和出现率。结果: (1) 主动脉上窦:MRI 显示20 例,占95 % ,其形态有半圆形、三角形、新月形和不规则形。(2) 横窦:71 .4 % 病例MRI 显示横窦,呈弧线或菱形腔隙。(3) 斜窦:显示9 例,呈梭形或短线样。(4) 左肺动脉隐窝:显示6 例,呈新月形。(5) 左、右肺静脉隐窝:显示左侧2 例,右侧1 例。(6) 上腔静脉后隐窝:未显示。心包隐窝均呈T1 及T2 低信号。结论: MRI 可清楚显示心包隐窝的解剖结构。

Objective: To mastering the normal MR imaging of sinus and recesses of the pericardium, it has clinical value to diagnose and differentiate.Materials and Methods:Four cadavers of serial thorax sections and two isolated cardiac specimens with intact pericardium were chosen. MRI scan was performed in 21 cases having no pericardial disease. Compared to the anatomy of the normal specimen, the shape, position and the syntopie, as well as the occurrence rate, of sinus and recesses of the pericardium on MRI were analyzed.Results:(1) On MRI, the superior pericardial recess was seen in 20 cases (95%), appearing as semicircle line, triangle, crescent or irregular. (2) The transverse sinus of the pericardium was demonstrated in 15 cases (71.4%), manifesting as curve line or rhomboid space. (3) The oblique sinus was revealed in 9 cases, presenting as spindle shape or short line. (4) The left pulmonary recess was showed in 6 cases, assuming as crescent. (5) The left and right pulmonary venous recess was presented in 2 and 1 case, respectively. (6) In no case of this study the postcaval recess was appeared. All recesses and sinuses of the pericardium had long T 1 and short T 2 intensity signal on MRI.Conclusion: MRI can clearly demonstrate the anatomy of the pericardium, very useful in differentiating normal from abnormal.