1.5T MRI分析扩张型心肌病左心室结构及心功能的诊断价值

摘要

目的 探讨1.5T磁共振成像(MRI)对原发性扩张型心肌病(IDCM)患者左心室结构及心功能的诊断价值.方法 选择该院2016年1-12月诊治的IDCM患者67例(IDCM组),选择同时期45例健康志愿者为对照组,分析两组对象左心室结构参数[舒张末期内径(EDD)与收缩末期内径(ESD)、致密化厚度(C)、肌小梁厚度(NC)、室间隔基底段厚度(IVS)、短轴缩短率(△D)、室壁增厚率(△T)]及心功能状态[左心室舒张末期血容量(EDV)与收缩末期血容量(ESV)、射血分数(EF)、每搏输出量(SV)、心输出量(CO)].结果 IDCM组患者的NC、NC/C、IVS、EDD、ESD、左心室舒张末期室壁厚度(TDD)、ESV及EDV均大于对照组,而C、C/WS、△D、△T、心肌质量(MM)、左心室收缩末期室壁厚度(TSD)、CO、EF及SV均小于对照组,除C、IVS参数外,组间比较差异有统计学意义(P＜0.05).IDCM组患者中,与Ⅰ～Ⅱ级比较,Ⅲ、Ⅳ级患者ESV、EDV增加,SV、CO及EF减少,均差异有统计学意义(P＜0.05);随着级数增加ESV及EDV值增加,SV、CO及EF减小,Ⅲ、Ⅳ级比较,差异有统计学意义(P＜0.05).结论 MRI可早期分析IDCM患者左心室结构参数与心功能状态,可有效定性地预判心功能情况.%Objective To investigate the diagnostic value of 1.5T magnetic resonance imaging(MRI) in the left ventricular structure and cardiac function of the patients with primary dilated cardiomyopathy(IDCM).Methods Sixty-seven patients with ID-CM(IDCM group) in this hospital from January to December 2016 were selected and contemporaneous 45 healthy volunteers served as the control group.The left ventricular structure parameters[end diastolic diameter(EDD),end systolic diameter(ESD),densifying thickness (C),trabecular thickness (NC),interventricular septal basement thickness (IVS),short axis shortening rate (△D),wall thickening rate(△T)],and cardiac function status[left ventricular end diastolic blood volume(EDV),end-systolic blood volume (ESV),ejection fraction(EF),stroke volume(SV) and cardiac output(CO)] were analyzed in the two groups.Results The levels of NC,NC/C,IVS,EDD,ESD,TDD,ESV and EDV in the IDCM group were higher than those in the control group,while C,C/IVS,△D,△T,MM,TSD,CO,EF and SV were smaller than those in the control group,except for C and IVS,the difference in the intergroup comparison was statistically significant(P＜0.05).In the IDCM group,compared with the grade Ⅰ-Ⅱ,ESV and EDV in the grade Ⅲ and Ⅳ were cncreased,while SV,CO and EF decreased,the difference statistically significant(P＜0.05).With the grade increase and ESV and EDV values were increased,SV,CO and EF were decreased,the difference had statistical significance (P＜0.05).Conclusion MRI can early analyze the left ventricular structure parameters and cardiac function status in the patients with IDCM,and can pre-judge the heart function situation effectively and qualitatively.