磁共振延迟增强成像在疑诊心脏淀粉样变患者中的应用

孙家瑜; 张庆; 程巍等

磁共振延迟增强成像在疑诊心脏淀粉样变患者中的应用

Late Enhancement of Cardiac MRI in Patients with Suspicious Cardiacamyloid

摘要

摘要: 【摘要】目的评价磁共振延迟增强成像在临床疑诊心脏淀粉样变患者中的鉴别诊断价值。方法纳入临床疑诊心脏淀粉样变患者6例。采用电影序列评价双心室功能。在经静脉团注钆喷葡胺0.15 mmol/kg后5～15 min采用反转恢复小角度激发梯度回波序列（IR-turbo Flash）行心脏延迟增强成像。最后结合心室功能、形态以及延迟成像特征进行分析。结果 6例患者中，其中4例延迟成像呈现典型的左室内膜下环形强化，符合心脏淀粉样变的影像特征，临床及（或）病理诊断也肯定了淀粉样变诊断。另2例患者没有延迟强化或不具备特征性强化，临床也排除了淀粉样变诊断。结论磁共振延迟增强成像在临床疑诊心脏淀粉样变患者中具有较高的鉴别诊断价值，值得进一步推广。

Abstract: 【Abstract】 Objective To determine the differential diagnostic value of myocardial delayed enhancement of cardiac MRI on suspicious cardiac amyloid.Methods Six patients with suspicious cardiac amyloidosis were scanned on a Siemens 3.0 T scanner. Late gadolinium enhancement (LGE) was performed 5-15 min after bolus injection with gadolinium (0.15 mmol/kg) in the patients. Their ventricular function, morphology and LGE characteristics were analyzed. Results Cardiac amyloid was confirmed in 4 cases, in which LGE showed concentric subendocardial enhancement. The 2 cases without such LGE type were also excluded from cardiac amyloid by clinical pathology. Conclusion Late gadolinium enhancement of cardiac MRI is an effective diagnostic tool for differentiating cardiac amyloid.

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