多排CT诊断肥厚型心肌病：与MRI对照

MDCT assessment of hypertrophic cardiomyopathy:Comparison with MRI

目的观察多排CT(MDCT)评价肥厚型心肌病(HCM)患者的心脏形态、功能和心肌纤维化等的准确性。方法对临床诊断为HCM的60例患者行CT动脉期、延迟期扫描及心脏MR形态、延迟强化检查。比较二者在左心室室壁厚度、射血分数(EF)、每搏输出量(SV)、左心室心肌质量(LVM)、心输出量(CO)、心脏指数(CI)、舒张末期左心室容积(EDV)、收缩末期左心室容积(ESV)、延迟强化病灶定性及定量诊断方面的异同。结果 60例患者共1020个心肌节段,CT与MRI所测左心室室壁厚度的相关性好(r=0.895,P<0.001),且CT测量的心功能参数均与MRI结果呈正相关。延迟增强检查证实CT与MR在检出心肌纤维化病灶方面具有高度相关性(r=0.98,P<0.01)。结论心脏CT检查可提供HCM患者心肌冠状动脉的形态及功能信息。

Objective To observe the diagnostic accuracy of multi-detector CT （MDCT） in assessing myocardial function and myocardial fibrosis of hypertrophic cardiomyopathy （HCM） compared with cardiac MRI. Methods Sixty consecutive patients confirmed of HCM clinically underwent cardiac CT and MRI. CT images were acquired in the arterial phase and the late phase. Cardiac MRI was performed with morphological and delay contrast-enhanced examinations. Left ventricular wall thickness, ejection fraction （EF）, stroke volume （SV）, left ventricle mass （LVM）, cardiac output （CO）, cardiac index （CI）, left ventricular end-diastolic volume （EDV）, left ventricular end-systolic volume （ESV）, qualitative and quantitative diagnosis of lesioffs delayed enhancement were compared between CT and MRI. Results Sixty patients had 1020 myocardi- al segments. LV wall thickness measured with CT correlated with MRI results （r=O. 895, P〈0. 001）. Other cardiac function indexes, including SV, EF, LVM, EDV and ESV of CT correlated well with MRI. CT delayed enhancement in detecting myocardial fibrosis lesions had excellent correlation with MR delayed enhancement （r= 0.98, P〈0.01）. Conclu- sion Comprehensive cardiac CT can provide morphological and functional information of myocardium and coronary arter- ies.