中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2011年
1期
45-48
,共4页
闫朝武%李华%赵世华%蒋世良%陆敏杰%张岩%凌坚%韦云青%杨敏福%方纬%赵红
閆朝武%李華%趙世華%蔣世良%陸敏傑%張巖%凌堅%韋雲青%楊敏福%方緯%趙紅
염조무%리화%조세화%장세량%륙민걸%장암%릉견%위운청%양민복%방위%조홍
心肌梗死%磁共振成像%心脏室壁瘤
心肌梗死%磁共振成像%心髒室壁瘤
심기경사%자공진성상%심장실벽류
Myocardial infarction%Magnetic resonance imaging%Heart aneurysm
目的 探讨心脏磁共振成像(MRI)鉴别诊断心肌梗死后左心室真、假性室壁瘤的价值.方法 分析经病理证实的心肌梗死后左心室室壁瘤患者共26例(男22例,女4例).所有患者均行心脏MRI、超声心动图及冠状动脉造影检查,并与病理检查结果对照.结果 患者平均年龄(59.3±9.3)岁.其中胸闷气短24例,15例伴发高血压.超声心动图检查诊断左心室真性室壁瘤22例,假性室壁瘤4例;左心室附壁血栓5例,左心室射血分数为36.9%±9.1%.心脏MRI发现24例患者受累左心室壁厚度＜5.5 mm,2例患者厚度5.5～8.0 mm.24例患者左心室室壁存在矛盾运动,2例患者受累室壁无运动;左心室舒张末期横径(67.8±9.3)mm,室壁瘤最宽处直径(35.1±13.8)mm.心脏MRI诊断真性室壁瘤23例,假性室壁瘤3例,7例患者左心室存在附壁血栓.与病理结果对照,心脏MRI诊断结果与病理一致,而超声心动图检查误诊假性室壁瘤1例,漏诊左心室附壁血栓2例.结论 心脏 MRI 能够准确鉴别心肌梗死后左心室真、假性室壁瘤.
目的 探討心髒磁共振成像(MRI)鑒彆診斷心肌梗死後左心室真、假性室壁瘤的價值.方法 分析經病理證實的心肌梗死後左心室室壁瘤患者共26例(男22例,女4例).所有患者均行心髒MRI、超聲心動圖及冠狀動脈造影檢查,併與病理檢查結果對照.結果 患者平均年齡(59.3±9.3)歲.其中胸悶氣短24例,15例伴髮高血壓.超聲心動圖檢查診斷左心室真性室壁瘤22例,假性室壁瘤4例;左心室附壁血栓5例,左心室射血分數為36.9%±9.1%.心髒MRI髮現24例患者受纍左心室壁厚度＜5.5 mm,2例患者厚度5.5～8.0 mm.24例患者左心室室壁存在矛盾運動,2例患者受纍室壁無運動;左心室舒張末期橫徑(67.8±9.3)mm,室壁瘤最寬處直徑(35.1±13.8)mm.心髒MRI診斷真性室壁瘤23例,假性室壁瘤3例,7例患者左心室存在附壁血栓.與病理結果對照,心髒MRI診斷結果與病理一緻,而超聲心動圖檢查誤診假性室壁瘤1例,漏診左心室附壁血栓2例.結論 心髒 MRI 能夠準確鑒彆心肌梗死後左心室真、假性室壁瘤.
목적 탐토심장자공진성상(MRI)감별진단심기경사후좌심실진、가성실벽류적개치.방법 분석경병리증실적심기경사후좌심실실벽류환자공26례(남22례,녀4례).소유환자균행심장MRI、초성심동도급관상동맥조영검사,병여병리검사결과대조.결과 환자평균년령(59.3±9.3)세.기중흉민기단24례,15례반발고혈압.초성심동도검사진단좌심실진성실벽류22례,가성실벽류4례;좌심실부벽혈전5례,좌심실사혈분수위36.9%±9.1%.심장MRI발현24례환자수루좌심실벽후도＜5.5 mm,2례환자후도5.5～8.0 mm.24례환자좌심실실벽존재모순운동,2례환자수루실벽무운동;좌심실서장말기횡경(67.8±9.3)mm,실벽류최관처직경(35.1±13.8)mm.심장MRI진단진성실벽류23례,가성실벽류3례,7례환자좌심실존재부벽혈전.여병리결과대조,심장MRI진단결과여병리일치,이초성심동도검사오진가성실벽류1례,루진좌심실부벽혈전2례.결론 심장 MRI 능구준학감별심기경사후좌심실진、가성실벽류.
Objective To observe the value of cardiac magnetic resonance imaging(MRI)for differentiation of true from false left ventricular aneurysm in patients after myocardial infraction(MI).Methods Twenty-six patients[22 males/4 females, mean age(59.3 ± 9. 3)years]with left ventricular aneurysm after MI were imaged with MRI, echocardiography and coronary angiography. The respective findings were compared with surgical pathology results. Results There were 24 patients with dyspnea and 15patients with hypertension. LVEF measured by echocardiography was 36. 9% ±9. 1% in this patient cohort.Cardiac MRI showed that the left ventricular end diastolic wall thickness was thinner than 5.5 mm in 24cases, and between 5.5 to 8 mm in 2 cases. The dimension of left ventricle was(67. 8 ± 9. 3)mm.Dyskinesia presented in 24 cases, and akinesia in 2 cases. Delayed enhancement was shown in all cases by MRI. Cardiac MRI detected left ventricular true aneurysm in 23 cases, false aneurysm in 3 case and left ventricular thrombi in 7 cases. The diagnosis by magnetic resonance imaging corresponded well to pathological findings. Echocardiography misdiagnosed pseudoaneurysm in 1 patient, and failed to detected left ventricular thrombi in 2 cases. Conclusion Cardiac MRI could correctly differentiate true from false left ventricular aneurysm in patients after MI.
