CAJ | 학술논문

目的分析孤立性左心室心肌致密化不全(ILVNC)患者的心肌灌注受损情况,及其与心脏MRI结果之间的关系.方法前瞻性入选19例(男14例,女5例,年龄15 ～ 76岁)经心脏MRI确诊的ILVNC患者,同期行99Tcm-MIBI SPECT MPI.采用标准的17节段法分析MRI及SPECT图像.计算MRI所示各节段心肌非致密层(NC)与致密层(C)厚度比值(NC/C),NC/C＞2.3者诊断为心肌致密化不全.计算并比较致密不全节段和致密化节段延迟强化(DE)出现率及心肌灌注异常的出现率.两样本率的比较采用x2检验;lgLVEF(LVEF由MRI测定)和心肌灌注受损节段数、致密化不全节段数和DE节段数的关系采用Pearson或Spearman法分析.结果 19例患者中16例(84.2％) MPI出现灌注受损;MRI示19例共有致密化不全节段107个和致密化节段216个,灌注异常出现率分别为33.6％(36/107)和31.9％(69/216),差异无统计学意义(x2=0.09,P＞0.05).共31个节段出现DE,致密化不全节段和致密化节段DE出现率分别为5.6％(6/107)和11.6％ (25/216),差异也没有统计学意义(x2=2.94,P＞0.05).DE节段灌注异常出现率高于非DE节段[54.8％(17/31)与30.1％(88/292);x2=7.80,P＜0.01].lgLVEF与致密化不全节段数、DE节段数、灌注受累节段数间相关系数均无统计学意义(r=-0.35、0.15和-0.34,均P＞0.05).结论大部分ILVNC患者存在不同程度的心肌血流灌注受损,MRI所示致密化不全和非致密化不全心肌均可出现;心肌灌注受损在该病的发生及进展中的作用尚需进一步研究.
목적 분석고립성좌심실심기치밀화불전(ILVNC)환자적심기관주수손정황,급기여심장MRI결과지간적관계.방법 전첨성입선19례(남14례,녀5례,년령15 ～ 76세)경심장MRI학진적ILVNC환자,동기행99Tcm-MIBI SPECT MPI.채용표준적17절단법분석MRI급SPECT도상.계산MRI소시각절단심기비치밀층(NC)여치밀층(C)후도비치(NC/C),NC/C＞2.3자진단위심기치밀화불전.계산병비교치밀불전절단화치밀화절단연지강화(DE)출현솔급심기관주이상적출현솔.량양본솔적비교채용x2검험;lgLVEF(LVEF유MRI측정)화심기관주수손절단수、치밀화불전절단수화DE절단수적관계채용Pearson혹Spearman법분석.결과 19례환자중16례(84.2％) MPI출현관주수손;MRI시19례공유치밀화불전절단107개화치밀화절단216개,관주이상출현솔분별위33.6％(36/107)화31.9％(69/216),차이무통계학의의(x2=0.09,P＞0.05).공31개절단출현DE,치밀화불전절단화치밀화절단DE출현솔분별위5.6％(6/107)화11.6％ (25/216),차이야몰유통계학의의(x2=2.94,P＞0.05).DE절단관주이상출현솔고우비DE절단[54.8％(17/31)여30.1％(88/292);x2=7.80,P＜0.01].lgLVEF여치밀화불전절단수、DE절단수、관주수루절단수간상관계수균무통계학의의(r=-0.35、0.15화-0.34,균P＞0.05).결론 대부분ILVNC환자존재불동정도적심기혈류관주수손,MRI소시치밀화불전화비치밀화불전심기균가출현;심기관주수손재해병적발생급진전중적작용상수진일보연구.
Objective To investigate the myocardial perfusion abnormalities in patients with isolated left ventricular noncompaction (ILVNC) and analyze the correlation between MPI and MRI.Methods Nineteen patients (14 males,5 females,age range:15-76 years) with ILVNC diagnosed by cardiac MRI were recruited.All patients underwent 99Tcm-MIBI MPI.Both MPI and cardiac MRI were analyzed using a 17-segment model.The thickness ratio of the non-compacted to compacted layers of myocardium (NC/C) was calculated,and segments with NC/C＞2.3 were considered as noncompaction.The incidences of delayed enhancement (DE) and myocardial perfusion abnormalities in non-compacted segments and compacted segments were calculated.x2 test was used for categorical data.The Pearson and Spearman correlation coefficient were used to assess the relationship between the numbers of myocardial segments with myocardial perfusion abnormalities/noncompaction/DE and lgLVEF.Results Of 19 patients,myocardial perfusion abnormality was found in 16 (84.2％) patients.The incidences of perfusion abnormality were 33.6％ (36/107) in non-compacted segments and 31.9％ (69/216) in compacted segments,respectively (x2=0.09,P＞0.05).There were 31 segments with DE.The incidences of DE were 5.6％ (6/107) in non-compacted segments and 11.6％ (25/216) in compacted segments,respectively (x2 =2.94,P＞0.05).The incidence of reduced perfusion was higher in segments with DE than those in segments without DE (54.8％ (17/31) vs 30.1％ (88/292) ; x2 =7.80,P＜0.01).The lgLVEF and the numbers of myocardial segments with noncompaction/DE/myocardial perfusion abnormalities were not correlated(r=-0.35,0.15,-0.34,all P＞0.05).Conclusion Most patients with ILVNC have myocardial perfusion abnormality,which can be observed both in non-compacted and compacted myocardium.Further research is required to elucidate the role of myocardial perfusion abnormality in ILVNC.