摘要
目的对原发性扩张型心肌病（IDCM）患者进行静息MPI和心脏磁共振延迟增强成像（DE—MRI）的对比分析，探讨2种诊断方法不同图像特征之间的对应关系。方法40例确诊为IDCM的住院患者，均行99Tcm-MIBI静息MPI和DE-MRI，间隔不超过7d。静息心肌灌注图像分为2种特征：弥漫性放射性减低和节段性放射性减低或缺损；DE—MRI分为4种类型：（1）无延迟强化；（2）壁间延迟强化；（3）内膜下延迟强化；（4）透壁性延迟强化。两样本率的比较采用，检验。结果在40例患者的静息MPI中，心肌放射性分布呈弥漫性减低19例（47．5％），呈节段性减低或缺损21例（52．5％）；两者DE-MRI延迟强化的发生率分别为26．3％（5／19）与85．7％（18／21），差异有统计学意义（X2=14．401，P〈0．001）。对18例节段性放射性异常和延迟强化的患者按心肌节段分析，灌注正常、灌注减低与灌注缺失3组DE—MRI分型构成分别为112：35：2：5，98：23：7：1，13：0：5：5，其中正常组与缺失组、减低组与缺失组之间差异有统计学意义（，值为29．183与25．110，P均〈0．001）。结论IDCM患者MPI既可以表现为典型的弥漫性放射性减低，也可表现为节段性放射性减低或缺损，后者DE—MRI出现延迟强化的比例较高。
Objective To compare 99Tcm-MIBI MPI with delayed enhancement MRI （DE-MRI） in patients with idiopathic dilated cardiomyopathy （IDCM）, Methods Forty patients with IDCM were included. They underwent both rest 99Tcm-MIBI myocardial perfusion imaging and DE-MRI within 7 days. 99Tcm- MIBI MPI was performed to identify diffuse or segmental abnormal perfusion patterns including reduced or defect perfusion segments. DE-MRI images were divided into 4 categories： no delayed enhancement, septal, subendocardial and transmural delayed enhancement. χ2 test was used for data analysis. Results Diffuse and segmental perfusion abnormality on 99Tcm-MIBI MPI were found in 19 （47.5%） and 21 （52.5%） patients respectively, while DE-MRI enhancement was simultaneously found in 5 patients of the former （5/ 19, 26.3% ） and 18 （18/21, 85.7% ） of the latter （χ2 = 14.401, P〈0.001）. For those （n = 18） with both segmental perfusion abnormality and DE-MRI enhancement, the number of segments of the 4 DE-MRI categories were 112： 35： 2： 5, 98： 23： 7： 1, and 13： 0： 5：5 for normal, reduced and defect perfusion segments respectively. A significant difference was found in the DE-MRI enhancement categories between normal and defect perfusion segments （χ2 = 29. 183, P 〈 0.001 ） and between reduced and defect peffusion segments as well （χ2 = 25.110, P 〈 0.001 ）. Conclusions Both diffuse and segmental perfusion abnormalities on 99Tcm-MIBI MPI can be found in patients with IDCM. DE-MRI enhancement is more frequently found in patients with segmental perfusion abnormality.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2011年第4期245-249,共5页
Chinese Journal of Nuclear Medicine
