心肌致密化不全的临床特点及影像学诊断

Clinical characteristics and imaging diagnosis of noncompaction of ventricular myocardium

目的:探讨心肌致密化不全(NVM)的临床和影像学特点。方法:回顾分析16例NVM患者的临床表现及相关检查结果。结果:NVM患者无典型临床表现和特异性心电图改变。12例行冠状动脉造影未见明显冠状动脉狭窄改变。10例胸片显示心影增大。15例心脏磁共振成像与多普勒超声心动图结果相符合,1例右室型NVM磁共振心脏成像结果难以诊断。在多普勒超声心动图上,12例为左室型,3例为双室型,1例为右室型,均可见NVM典型改变。结论:对不明原因心影增大、冠状动脉造影结果正常的患者,需要考虑NVM,心脏磁共振成像和多普勒超声心动图检查可以进一步明确诊断。

Objective ： To investigate the clinical and imaging features of noncompaction of ventricular myocardium （NVM）. Method：The clinical manifestations and imaging features of 16 NVM patients were retrospectively analyzed. Result： There was no typical clinical manifestation and specific change of ECG in patients with NVM. Twelve cases which underwent coronary angiography had no significant coronary stenosis. Ten cases had enlarged heart shadow on chest X-ray. The diagnosis of magnetic resonance imaging （MRI） was consistent with the cardiac Doppler echocardiography in 15 patients, but the MRI of one patient with right ventricular NVM was difficult to be determined. Typical changes of NVM were showed in Doppler echocardiography in all the patients, 12 cases were left ventricular, three cases were both of ventricular, and one case was right ventricle. Conclusion.. NVM should be taken into consideration when heart shadow enlarged with unknown causes and normal coronary angiography was found. Cardic MRI and Doppler echocardiography are helpful to confirm the diagnosis of NVM.