致心律失常性右心室发育不良多层螺旋CT表现

Multi-slice Spiral CT Manifestations of the Arrhythmogenic Right Ventricular Dysplasia

目的探讨多层螺旋CT(MSCT)对致心律失常性右心室发育不良(ARVD)的诊断价值。资料与方法对34例临床拟诊为ARVD的患者行右心室CT造影,按照国际ARVD诊断标准确诊16例ARVD,选取15例非ARVD患者作为对照。以长轴、短轴、四腔面进行多平面重组(MPR)观察心脏结构和形态改变,分析ARVD患者的MSCT右心室造影特征。结果 16例ARVD患者均经MSCT正确诊断,其中右心室脂肪浸润14例,包括心尖部11例、下壁8例、前壁5例、漏斗部前壁5例、膈面3例、乳头肌4例、肌小梁和节制索6例、全右心室游离壁1例;右心室壁扇贝征5例;右心室过度小梁化16例;右心室壁变薄11例;室腔扩大16例。结论 ARVD的右心室MSCT造影图像具有一定的诊断特征性,右心室壁扇贝征和过度小梁化为其特征性影像学表现。

Purpose To investigate the diagnostic value of the arrhythmogenic right ventricular dysplasia （ARVD） using multi-slice spiral CT （MSCT）. Materials and Methods Thirty-four patients who were suspected as ARVD received right ventricular radiography. including 16 ARVD patients and 15 non-ARVD patients regarded as control group. The structural and shaped change of heart on reconstructed images of long axis, short axis and four cavity surface and analyze were observed, and MSCT features of right ventricular radiography characteristics were analyzed for ARVD patients. Results Sixteen cases of ARVD were correctly diagnosed by MSCT, and 14 cases had fatty infiltration including 11 cases of apex of heart, 8 cases of inferior wall, 5 cases of anterior wall, 5 cases of anterior wall of funnel area, 3 cases of diagram, 4 cases of papillary muscle, 6 cases of muscular trabecula and moderator band and 1 case of whole right ventricular free wall. Five cases showed scallop sign, 16 cases excessive trabecular change, 11 cases thinned changes, and 16 cases enlarged changes of right ventricular wall. Conclusion MSCT features of right ventricular for ARVD have relative diagnostic characteristics, and the scallop sign and excessive trabecular change of right ventricular wall are its specific imaging characteristics.