对比心肌灌注显像与心脏磁共振延迟增强成像在原发性扩张型心肌病中的诊断价值

摘要

Objective To compare MPI (myocardial perfusion imaging) and DE-MRI(delayed hyperenhancement cardiac magnetic resonance) in the diagnosis ofidiopathic dilated cardiomyopathy. Methods a retrospective analysis of the clinical data of 80 cases in our hospital from 2012 May to 2014 September wereidiopathic dilated cardiomyopathy patients, underwent DE-MRI and MPI, the time interval is less than 7d. DE-MRI shows no delay, subendocardial delayed,transmural delayed, wall delayed enhancement, and MPI revealed diffuse andradioactive radioactive segmental defect or reduced, on two sample rate for X -test. Results (1) the MPI and DE-MRI results:the 80 MPI patients, including 38 cases (47.50%) myocardial radioactive distribution shape, accompa-nied bydiffuse reduction of DE-MRI delayed enhancement, the incidence rate was 26.32% (10/38); 42 cases (52.50%) showed segmental defect or reduce theshape, DE-MRI delay strengthening incidence 85.71% (36/42), enhancement wasthere was signifi-cant difference between two group delay of DE-MRI (P < 0.05);(2) the DE-MRI typing results: Based on the perspective of my-ocardial segments,36 cases of delayed enhancement and segmental radioactive anomaly aredivided into A (normal perfusion), B (low perfusion) and C (perfusion defect)three groups in DE-MRI type composition, group A (112:35:2:5) and B group(98:23:7:1) and group C (13:O:5:5) to compare the difference was significant (P < 0.05). Conclusion MPI features for DE-MRI showed multi-ple and radioactivesegment diffuse decreased, the former DE-MRI easy to show delayed enhancement, clinical attention should be paid.%目的：对比MPI（心肌灌注显像）与DE-MRI（心脏磁共振延迟增强成像）在原发性扩张型心肌病中的诊断价值。方法回顾性分析该院2012年5月—2014年9月收治的80例原发性扩张型心肌病患者的临床资料，均接受DE-MRI及MPI，间隔时间＜7 d。DE-MRI显现无延迟、内膜下延迟、透壁性延迟、壁间延迟强化，而MPI显现放射性弥漫性及放射性节段性缺损或减低，对两样本率行X2检验。结果（1）MPI及DE-MRI结果：80例患者行MPI，其中38例(47.50％)心肌呈放射性分布状，伴有弥漫性减低情况，DE-MRI延迟强化发生率为26.32％(10/38)；42例(52.50％)呈节段性缺损或减低状，DE-MRI延迟强化发生率为85.71％(36/42)，两组DE-MRI延迟强化发生率比较差异具有统计学意义（P＜0.05）；（2）DE-MRI分型。结果立足于心肌节段角度，将36例延迟强化及节段性放射性异常者划分为A（灌注正常）、B（灌注减低）、C（灌注缺失）三组，在DE-MRI分型组成上，A组（112：35：2：5）与B组（98：23：7：1）及C 组（13：0：5：5）比较差异具有统计学意义（P＜0.05）。结论行DE-MRI者的MPI特征多表现为放射性节段性及放射性弥漫性减低，前者DE-MRI易显现延迟强化情况，临床上应引起足够重视。