磁共振成像与超声心动图对儿童肥厚型心肌病的诊断分析研究

Comparison of magnetic resonance imaging and echocardiography in the diagnosis of hypertrophic cardiomyopathy in children

目的探讨磁共振成像与超声心动图对儿童肥厚型心肌病(HCM)的诊断价值。方法回顾性分析12例儿童HCM患者的临床资料,患儿均进行磁共振成像和超声心动图检查,对两组诊断检查方法的结果进行比较和分析。结果 12例HCM儿童中均有不同部位或不同程度的心肌肥厚,磁共振成像可明确显示每例患者心肌增厚的部位和范围,超声心动图检出10例患者,诊断正确率为83.33%(10/12)。两种检测方法在心脏的室间隔、前壁、侧壁及后壁的厚度测量中,差异无统计学意义(t分别=0.07、1.17、1.65、1.43,P均>0.05),而在心尖部心肌厚度的测量中,磁共振成像测量结果明显大于超声心动图(t=2.32,P<0.05)。结论心脏磁共振成像与超声心动图在儿童HCM诊断中均有一定的应用价值,但是磁共振成像可全面显示HCM的解剖形态,为临床诊断提供直观、准确的心脏影像学参考,且在心尖HCM中的敏感性更高,可用于心尖HCM的明确诊断。

Objective To evaluate the diagnostic value of magnetic resonance imaging and echocardiography in children with hypertrophic cardiomyopathy.Methods A total of 12 cases of hypertrophic cardiomyopathy in children were retrospectively analyzed.All the children received magnetic resonance imaging and echocardiography,and the results of diagnostic examination methods in the two groups were compared and analyzed.Results All the 12 children with hypertrophic cardiomyopathy had different parts or degrees of cardiac hypertrophy.Magnetic resonance imaging could clearly show the location and scope of cardiac hypertrophy.Ten patients with hypertrophic cardiomyopathy were identified by echocardiography,and the accuracy was 83.33%(10/12).In the measurement of the thickness of the ventricular septum,anterior wall,lateral wall and posterior wall of the heart,there was no significant statistical difference between the two methods(t=0.07,1.17,1.65,1.43,P>0.05).While in the measurement of myocardical thickness of apex,the result of magnetic resonance imaging was significantly higher than that of echocardiography(t=2.32,P<0.05).Conclusion Both cardiac magnetic resonance imaging and echocardiography have certain application value in the diagnosis of hypertrophic cardiomyopathy in children.However,magnetic resonance imaging can comprehensively display the anatomical morphology of hypertrophic cardiomyopathy,provide more intuitive and accurate cardiac imaging reference for clinical diagnosis,and it has a higher sensitivity in detecting apical hypertrophic cardiomyopathy,which can be used for the definite diagnosis of apical hypertrophic cardiomyopathy.