醫(yī)學影像學-cardiovascular system留學生

Dr.HanxiongGuanDepartmentofRadiology,TongjiHospitalAboutmyselfImagingoftheHeartandGreatVessels示意圖sketchmapCT：ComputedtomographyMRI:MagneticresonanceimagingUSG:UltrasonographySPECT:SinglephotonemissionCTPET:PositronemissiontomographyEBCT：ElectronbeamCT(UltrafastCT)MSCT:MultislicespiralCTMDCT:MultidetectorspiralCTAbbreviationschapter1

ExaminationMethodsX-rayCTMRIUSGSPECT/PET

SPECTPlainfilm(fluoroscopy）－ＵＳＧ－ＭＲＩ—ＰＥＴEBCTangiographyMSCTMDCT

1．Fluoroscopy(透視）2．Plainfilm（平片）P-AviewRightanteriorobliqueview(firstoblique)：turnleft45°～60.ToviewtheenlargementofLA,Bariumtakingfromtheesophagusnecessary.Leftanteriorobliqueview(secondoblique)：turnright60。，Toviewtheenlargementofbothatriumandventricle.Leftlateralview：viewtheenlargementofleftatriumandventricle.X-rayExaminationExaminationMethodsExaminationMethodsSchematicdiagramofviewsP-ARAOExaminationMethodsLAOLeftLateralExaminationMethods3.CardiacCatheterization（心導管檢查）CatheterizationofRAandRV:pulmonaryangiography,diseaseofRAandRV(atrialseptaldefect)CatheterizationofLAandLVAortographyCoronaryangiographyExaminationMethodsAdvantages

Configuration,function,bloodstreamDisadvantages

Hurt,pain,reactionofcontrastmedia（造影劑）ExaminationMethodsExaminationMethodsConventionalCTScan:pericardialdisease,hearttumor,aneurysmandaorticdissection.Limitedusefortheheartmotionartifact.EBCT/UFCT:usedfordetectionofcoronaryarterycalcification,myocardialperfusion.RepresenttheuseofCTincirculatorysystem.MSCT/MDCT:scantime0.5s,withECG-gating,almostthesameeffectasEBCT,shorterexaminationtime,lesscost,highimagequality.CT

ExaminationExaminationMethodsIndicationsofCTCalciumoftheheartandgreatvesselsGreatvessels’diseaseTumorMyocardialinfarction,ventricleaneurysmCardiomyopathyPericardialdiseaseCongenitalheartdiseasePost-operationrecheck

MSCT1998,9ClinicallyusedArraysofdetectors:single24816

64ExaminationMethodsExaminationMethodsExaminationMethodsMultisliceCTExaminationMethodsMRIexamination成像平面選擇矢狀位定位像：顯示從心尖至心右緣的圖像四腔心平面成像：作為心臟長、短軸位定位像，觀察左右心房、左右心室、室間隔、二間瓣、三間瓣。垂直于室間隔的短軸位：顯示左房室前后壁、右房室前外下壁。平行于室間隔的長軸位：顯示左右室心尖部。解剖標準體位：橫軸位、冠狀位、矢狀位。SelectionofimagingplanesSagittalscoutviewFour-chamberplan:long-axis,short-axisShort-axisverticalLong-axisparallelStandardanatomyplanes:axis,coronary,sagittalExaminationMethods心臟解剖黑血技術(shù)（BlackBloodTechnique)心肌壁運動白血技術(shù)（WhiteBloodTechnique)心肌灌注(MyocardialPerfusion)冠狀動脈成像(CoronaryArteryMRA)ExaminationMethods黑血技術(shù)臨床應用顯示心肌結(jié)構(gòu)及信號心臟腫瘤心肌病心肌梗塞先天性心臟病右室發(fā)育不良心包膜及心包腔評價主動脈評價大血管病變BlackBloodTechniqueMyocardialstructureandsignsTumorCardiomyopathy,infarctionCongenitalheartdiseaseMalformationofRVPericardialdiseaseAortaDiseaseofgreatvesselsExaminationMethods白血技術(shù)臨床應用觀察心臟舒縮功能評價心肌運動計算射血分數(shù)計算心室壁收縮增厚率評價瓣膜情況WhiteBloodTechniqueviewsystolicanddiastolicmyocardialmotionCalculateejectionfractionthicknessratioofventriclewallevaluatevalveconditionExaminationMethodschapter2

NormalX-raymanifestationAHeart,greatvessels’normalprojection

1．P-Aview2/3liesleftonthesternummidline,1/3liesontheright，apextowardsleftinferior，basetowardsupperrightposterior，obliquelongitudinalaxis.twomarginsNormalX-raymanifestationNormalX-raymanifestationAortaarchLeftPAPAtrunkLVRVSuperiorvenacavaRightatriumInferiorvenacava

2．Rightanterioroblique（firstoblique）heartliesbetweensternumandspineNormalX-raymanifestation

3．Leftanterioroblique（secondoblique）heartandgreatvesselslierightofthespineNormalX-raymanifestation4.leftlateralviewNormalX-raymanifestationBBeatoftheheartandgreatvesselsLeftborderrepresentsthebeatofLV.Adductrapidlyduringsystolicperiodanddilateforthgraduallyduringdiastolicperiod.Atthesametime,thebeatoftheaortaandpulmonaryarteryintheoppositedirection.RightborderrepresentsthebeatofRA.BeatofenlargedRVmaytransfertotherightmargin.NormalX-raymanifestation

Csilhouette(輪廓）ofthehearthorizontalshape：heart/thoraxratio>0.5cardiacaxisdegree<45。obliqueshape：heart/thoraxratio＝0.545。verticalshape：heart/thoraxratio<0.5>45。NormalX-raymanifestation橫位心斜位心垂位心NormalX-raymanifestation橫位心斜位心NormalX-raymanifestation球形心(globular)垂位心NormalX-raymanifestationDSizeoftheheartandgreatvessels心胸比率ratioofthebiggesttransversediameteroftheheartandthebiggesttransversewidthofthethorax.Thebiggesttransversediameteroftheheart:Sumofverticaldistancefromthemostprotrudentpointtothemidline.Thebiggesttransversewidthofthethorax:Distancebetweentheinnermarginsofthethoraxatthelevelofrightdiaphragm.Normallyequaltoorlessthan0.5.NormalX-raymanifestation心胸比率測量圖sketchmapT1、T2：心橫徑，取心緣最突出部垂直于中

線；T：胸廓橫徑，于右膈頂取水平線達兩側(cè)

胸廓內(nèi)緣；OO＇：胸廓中線NormalX-raymanifestationchapter3

NormalCTmanifestation主動脈弓層面氣管分叉層面主動脈根部層面心室層面AortaarchplaneBifurcationoftracheaRootofaortaplaneVentricleplaneNormalCTmanifestation主動脈弓層面NormalCTmanifestationSubclaviana.Bronchiocephalica.Commoncarotida.BifurcationplaneAortarootplaneVentricleplaneNormalanatomyA.FrontwallB.FrontandlateralC.BackandlateralD.BackandinferiorE.InferiorF.IVSbelowG.IVSmiddleH.IVSupperChapter4

NormalMRImanifestation心肌心內(nèi)膜心腔心包大血管HeartmuscleEndocardiumHeartchamberPericardiumGreatvesselsNormalMRImanifestationNormalMRImanifestationNormalMRImanifestation4-ChamberNormalMRImanifestationLongAxisNormalMRImanifestationTriple-IRNormalMRImanifestationChapter5

basicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)LocationabnormitySizeandsilhouetteabnormityMotionabnormityCoronaryarteryabnormityBloodstreamabnormityPericardialpathologicalchangesFindingsofbasicpathologicalchanges(heart)1.Locationabnormity標準：心底與心尖之間軸線向下的指向心臟（內(nèi)臟正位、不定位）Mesocardiaaristocardia左位心(sinistrocardia)中位心右位心(右旋心)左旋心鏡面右位心

心臟（內(nèi)臟反位situsinverses）Findingsofbasicpathologicalchanges(heart)2.SizeandsilhouetteabnormityGeneralconfigurationabnormityMitralvalvetype(二尖瓣型)--pearAortatype（主動脈型）---shoeGeneralenlargedtype（普大型）Findingsofbasicpathologicalchanges(heart)心影呈梨形，心腰突出，左心緣下段圓鈍。主動脈球較小心影呈靴形，主動脈球突出，心腰凹陷，心左緣下段向左擴展Findingsofbasicpathologicalchanges(heart)EnlargementofLVPressureoverload:hypertension,aorticdisease,congenitalaorticobstructionVolumeoverload:mitraloraorticregurgitation,left-to-rightshuntDiseaseofheartmuscle:ischaemia,cardiomyopathyFindingsofbasicpathologicalchanges(heart)EnlargementofLVX線表現(xiàn)：①心尖向下、向左延伸；②相反搏動點上移；③左心室段延長、圓隆并向左擴展；④左前斜位旋轉(zhuǎn)60°時，左心室與脊柱重疊，室間溝向前下移位；⑤左側(cè)位，心后間隙變窄甚至消失，心后下緣的食管前間隙消失。Roundingofthecardiacapex----hypertrophyElongationoftheapextoleftortoleftanddownwards----dilatationLateralview:narrowordisappearofpost-cardiacspaceFindingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)Apexpointstoleftanddownwards,elongationofLVFindingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)EnlargementofRVPulmonaryhypertensionPulmonaryvalvedisease(incompetence)TricuspidvalvediseaseLeft-to-rightshuntFindingsofbasicpathologicalchanges(heart)EnlargementofRVX線表現(xiàn)：①右心室主要向前、向左、向后增大，心呈二尖瓣型；②心腰變?yōu)樨S滿或膨?。虎巯喾床珓狱c下移；④右前斜位，心前緣下段膨隆，心前間隙變窄；⑤左前斜位，心室膈段增長，室間溝向后上移位。Forwards,leftandbackwardscardiacwaistprotrudeOppositebeatpointdownwardsFirstobliqueview:disappearofpre-cardiacspaceFindingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)EnlargementofLAX線表現(xiàn)：①食管中段受壓向后移位；②心右緣出現(xiàn)增大的左心房右緣形成的弓影，心底部雙心房影；③心左緣可見左心耳突出，即第三弓影；④左主支氣管受壓抬高。Barium-filledesophagusbackwardsDoubleshadowofatriumLeftauricleprotrusionDisplacingtheleftmainbronchusFindingsofbasicpathologicalchanges(heart)Double–atriumshadow,auricularappendageprotrusionFindingsofbasicpathologicalchanges(heart)PulmonarycongestionandenlargementofLAEnlargementofRAHighbloodflow---atrialseptaldefectAcquiredtricuspidvalvedisease---stenosisorincompetenceCongenitaltricuspidvalvedisease---stenosisorincompetenceFindingsofbasicpathologicalchanges(heart)EnlargementofRAX線表現(xiàn)：①左前斜位，右心房段延長超過心前緣長度一半以上，膨隆，并與心室段成角②后前位，心右緣下段向右擴展、膨隆，最突出點位置較高。RightheartborderprotrudeorbulgestotherightRadiusofcurvatureincreasedFindingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)右心房的高度及橫徑擴大，同時伴右心室擴大。Findingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)3.Motionabnormity運動增強：高動力狀態(tài)hyperkineticstate；運動減弱hypomotility；運動消失：區(qū)域性無動力狀態(tài)(regionalunpoweredcondition)；局部矛盾運動(paradoxicalmotion)：運動功能失調(diào)狀態(tài)。Findingsofbasicpathologicalchanges(heart)4.Innerstructureabnormity

(內(nèi)部結(jié)構(gòu)異常)Septalabnormity(間隔異常)Valveabnormity(瓣膜異常)Heartwallabnormity(心壁異常)Heartchamberabnormity(心腔異常)Findingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)5.PericardialpathologicalchangesPericarditisPericardialeffusionConstrictivepericarditis:pericardiumthickness2.6mm，CT<4mmTumor:rare,primaryormetastaticFindingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)Findingsofbasicpathologicalchanges(heart)

Chapter6Findingsofbasicpathologicalchanges(greatvessels)Findingsofbasicpathologicalchanges(greatvessels)LocationabnormitiesMorphologyabnormitiesPulmonaryvesselandhilumabnormitiesFindingsofbasicpathologicalchanges(greatvessels)右位主動脈弓左上腔靜脈上腔靜脈梗阻主動脈瘤真性主動脈瘤D>4cm假性主動脈瘤手術(shù)、創(chuàng)傷RightaortaarchLeftsuperiorvenacavaSVCobstructionAneurysm:realaneurysmfalseaneurysmFindingsofbasicpathologicalchanges(greatvessels)Findingsofbasicpathologicalchanges(greatvessels)Findingsofbasicpathologicalchanges(greatvessels)PulmonaryvesselandhilumabnormitiesHilarshadow:concaveouteraspectAbove:superiorpulmonaryveinBlow:descendingbranchofthepulmonaryarteryDiameterofthedescendingbranchofthepulmonaryartery<15mm(women),<16mm(men)Findingsofbasicpathologicalchanges(greatvessels)Hilarabnormities:Enlargementofthehilum:pulmonaryarteryorveinhypertensionFindingsofbasicpathologicalchanges(greatvessels)

PulmonaryarteryabnormityPulmonaryhyperemia(肺充血）PulmonaryarteryhypertensionPulmonaryoligaemia（肺血減少）Findingsofbasicpathologicalchanges(greatvessels)肺充血后前位表現(xiàn)為肺動脈段膨隆，兩側(cè)肺門影增大。肺充血常見于左向右分流的先天性心臟病，如房或室間隔缺損、動脈導管未閉等，亦見于循環(huán)血量增加，如甲狀腺功能亢進和貧血等疾病。ConvexpulmonarysegmentEnlargementofthehilumAnemiaLeft-to-rightshuntHyperthyroidFindingsofbasicpathologicalchanges(greatvessels)Convexpulmonarysegment,dilatationofPAFindingsofbasicpathologicalchanges(greatvessels)Pulmonaryhypertension:systolicpressureinPAis2~4kPa(15~30mmHg),averagepressure2.7kPa(20mmHg).Systolicpressure>30mmHgoraveragepressure>20mmHg,meanshypertensionFindingsofbasicpathologicalchanges(greatvessels)X線表現(xiàn)：①肺動脈段突出；②肺門肺動脈及其大分支擴張③肺門肺動脈搏動增強；④右心室增大.ConvexpulmonarybayDilatationofPAandmainbranchesStrongpulseofPAEnlargementofRVFindingsofbasicpathologicalchanges(greatvessels)EnlargementofRVFindingsofbasicpathologicalchanges(greatvessels)

PulmonaryoligaemiaCongenitalheartdisease:PAstenosis,tricuspidvalvestenosisPulmonaryarterysmallLunghypertransluncent(透亮度增高）EmptyorconcavepulmonarybayFindingsofbasicpathologicalchanges(greatvessels)hypertransluncentFindingsofbasicpathologicalchanges(greatvessels)PulmonaryveinhypertensionImpairmentfunctionofvalvesorchambersofleftheartRiseinpressureinleftatriumPulmonaryveinhypertensionFindingsofbasicpathologicalchanges(greatvessels)PulmonaryveinhyperaemiaDistensionofupperlobeveinsandCompressionofthelowerlobeveins>25mmHg(plasmaosmoticpressure)---pulmonaryedema---interstitiallineB(edemaoftheinterlobularsepta)Blurringenlargedhilum肺門影增大，肺門血管邊緣模糊.下肺靜脈收縮變細，上肺靜脈擴張增粗。間隔線（KerleyB線），長約2～3cm，寬約1mm，為肺靜脈壓升高引起滲出液存留在小葉間隔內(nèi)所致。肺瘀血常見原因為二尖瓣狹窄和左心衰竭等。Findingsofbasicpathologicalchanges(greatvessels)CongestionandKerleylinevisualizedFindingsofbasicpathologicalchanges(greatvessels)Interstitialpulmonaryedema(間質(zhì)性肺水腫）KerleyA,B,ClinesAlveolarpulmonaryedema(肺泡性肺水腫）Bat’swingappearanceFindingsofbasicpathologicalchanges(greatvessels)Findingsofbasicpathologicalchanges(greatvessels)Findingsofbasicpathologicalchanges(greatvessels)ContinuedImagingDiagnosisoftheheartandgreatvesselsdisease1.Atrialseptaldefect(ASD)CongenitalHeartDiseasehemodynamicschangesSVCLARARVPAvolumeIVCXrayPAvolume:convexpulmonarysegment,hilumarterydilateMitralvalvetypesilhouetteSmallornormalaorticknucklePAhypertensionRVenlargedCTDirectsign:ASDIndirectsign:RA/RVenlargedPAdilateTwiceenhancementofRAMRIASDRA/RVenlargedPAdilate2.Patentductusarteriosus

(PDA,動脈導管未閉）VitalpartofthefetalcirculationAcontinuousmurmur---clinicalsignCommonlyassociatedwithothercongenitalheartdiseasePressureandvolumeoverloadingofthepulmonarycirculation—similartoVSDAnatomyclassificationCircularcylinder（圓柱型）Funnel（漏斗型）Defect（缺損型）Aneurysma-like（動脈瘤狀型）CircularcylinderFunnelDefectAneurysma-likeHemodynamicsLVoverloadingLVenlargedPDAL-RshuntPAoverloadingPA-AortashuntPAhypertension

cyanosis(紫紺)inlowerextremityXrayPulmonaryplethoraMildormoderateLVenlargementAorticknucklewidenFunnelsign---aorticarchprotrude（膨?。?descendingaortaadduct(內(nèi)收）CardiaccatheterizationMPAengorgejustafterdescendingaortaR-Lshunts---descendingaortaengorgeafterPAPassageofthecatheterthroughthecommunicationCTandMRIDisplaythecommunication(ductus)directly3.TetralogyofFallot（Fallot四聯(lián)征）ElementarylesionsInfundibularRVoutflowtractstenosisSubaorticVSD（室間隔缺損）RVhypertrophyOverridingaorta（主動脈騎跨）RVLVaortaPAhemodynamicspulmonaryperfusionRVpressureAorticflowShunt（分流）XrayMild:similartoPSorVSDCommon:Silhouette----shoeRVenlargedStraightorconcavepulmonarybayWidenaortaPulmonaryperfusiondecreaseSevere:collateralcirculationCTandMRIRVwallhypertrophyOverridingaortaWidenaortaInfundibularconstriction（漏斗部梗阻）SmallPAAcquiredheartdiseaseRheumaticheartdisease

(風濕性心臟病）Mitralstenosis(MS)Mitralinsufficiency(MI)Aorticstenosis(AS)Aorticinsufficiency(AI)Tricuspidstenosis(TS)andTIAssociatedvalvesdisease1.Mitralvalvestenosis

（二尖瓣狹窄）Clinicalsituation:Palpitation（心悸）,hemoptysis（咯血）,orthopnea（端坐呼吸）,hepatomagly（肝大）,lowerextremityedemaDiastolicrumblingmurmur（隆隆樣雜音）inapexECG:bicuspidvalvePwave,atrialfibrillation（房顫）Echocardiogram:greatvaluesfordiagnosisRheumaticheartdiseaseHemodynamicschanges（血流動力學）MVS---LApressure---lungcongestionLAenlargementPVpressurePApressureRheumaticheartdiseaseXrayfeatures:Heartsilhouette(輪廓）?whichatriumandventricleenlarged?changesofthevalve?Lungchanges?RheumaticheartdiseaseXrayfeatures:Cardiacenlargement:LA+RV,LAauricleAorticknuckle（主動脈球）decreasedsizeLVdecreasedsize,cardiacapexshiftup（上移）Mitralvalvecalcification---directsignLungcongestionandinterstitialedema,hemosiderinpigmentation（含鐵血黃素顆粒沉著）RheumaticheartdiseasePulmonarycongestion,LAenlargementRheumaticheartdiseasePulmonarycongestion,LAenlargementRheumaticheartdiseaseRheumaticheartdisease2.Mitralvalveincompetence（關(guān)閉不全）hemodynamicschangesMVI---LApressure---lungcongestionLAenlargementPVpressureLVenlargementPApressureRheumaticheartdiseaseXrayfeatures:Heartsilhouette?whichatrialandventricleenlarged?changesofthevalve?Lungchanges?RheumaticheartdiseaseXrayfeatures:Slightmitralregurgitation（返流）,cardiaccompensation（代償）-----normalsizeandsilhouetteLA+LVenlargementpulmonarycongestionRVenlargementNormalorsmallaorticknuckleRheumaticheartdiseasePulmonarycongestion,enlargementofRV,double-atriumRheumaticheartdiseaseOtherrheumaticheartvalvediseaseAorticvalvelesionTricuspidvalvelesionAssociatedvalvedisease（聯(lián)合瓣膜病）RheumaticheartdiseaseAIAITSASCTfeatures:Valvecalcification,sizeofatriumandventricle,thrombus（血栓）inLAMRIfeatures:observethevalvesRheumaticheartdiseaseRheumaticheartdiseaseRheumaticheartdiseaseCoronaryatheroscleroticheartdiseaseClinicalsituationLatentcoronaryheartdisease（隱匿性冠心?。〢nginapectoris（心絞痛）Myocardialinfarction（心肌梗塞）PostinfarctioncomplicationsCardiacrhythmdisorder（心律紊亂）Heartfailure（心衰）Primarysuddendeath（猝死）XrayfeaturesNormalplainfilmSilhouette:aortictypeorgeneralenlargedAcuteheartfailure:LVenlargement+edemaChronicheartfailure:LA+LVenlarged,pulmonarycongestion/edemaPostinfarctionsyndrome:pericardialeffusion,hydrothorax（胸腔積液）PostinfarctioncomplicationsVentricularaneurysm（室壁瘤）Interventricularperforation（室間隔穿孔）Papillarym.rupture(乳頭肌斷裂）CTfeaturesPlainscan:calcificationMyocardialinfarction:LocalmyocardiumthinningSystolicthickeningratioSegmentalabnormalwallmotionGeneralorsegmentalEFTwostenosisofRCAEstimationforlumenstenosisStage1：normalStage2：mildstenosis，<30%Stage3：moderatestenosis30％～50%Stage4：severestenosis，50％～90％Stage5：subtotalobstruction，>90%Stage6：totalobstructionMRIfeaturesAngina:cineMRI,segmentalmotionAcuteinfarction:T2WIhighsignal,myocardiumthinning,wallmotionOldinfarction:T2WIlowsignalComplicationsChronicpulmonaryheartdiseaseClinicalsituationLong-termcough,expectoration(咳痰),empsyxis(咯血),asthma(哮喘)andpalpitation(心悸)etc.Signsofemphysema(肺氣腫)andbronchitis,barrel-shapedthorax(桶狀胸)Xray：PAhypertensionRVenlargementChronicbronchitis,extensivefibrosisandemphysema(慢性支氣管炎，廣泛肺組織纖維化及肺氣腫)Chronicbronchitis,emphysemaPrimarycardiomyopathyDilatedcardiomyopathy（擴張性心肌?。〩ypertrophiccardiomyopathy（肥厚性心肌?。㏑estrictivecardiomyopathy（限制性心肌?。?/p>

Hypertrophiccardiomyopathy-HCMMicroscopicFeaturesMyocardialhypertrophy;Grossdisorganizationofthemusclebundles;Cell-to-celldisarray.標本ImagingFindingsXrayfindings:Cardiacsilhouettemayrangefromnormaltomarkedlyincreased;Lungcirculationalwaysnormal.MarkedlyenlargementheartmayfindInterstitialpulmonaryedema.Leftatrialenlargementfrequentlyobservedduotosignificantmitralregurgitation.CT.MRIfindingsAsymmetrichypertrophy1.5timestothethicknessofposteriorwallofLVChambersoftheheartnarrowordeformation(心腔縮小或變形)outflowwaystenosis(流出道狹窄)PathologicalmyocardiumlongT2signal(病變心肌多長T2信號)MyocardialenhancementondelayedimagesHCM:Tagging

DilatedcardiomyopathyDefinedclinicallybydilatationandimpairedcontractionofoneorbothventriclesCommoncauseofcongestiveheartfailureandthemostcommondiagnosisinpatientsreferredtocardiactransplantationMicroscopicFeaturesMyocytehypertrophyanddeath,andreplacementfibrosiswithvariableinvolvementoftheconductsystemImagingFindingsXrayfindingsUsuallyrevealcardiacenlargementandpulmonaryredistributionsuggestiveofcongestiveheartfailureonthebasisofleftventriculardysfunctionMRI、CTFindingsMainlyinvolvedLVChambersenlargedThicknessofthewallnormalorslightlyincreased(心室壁正?；蛏栽龊?Myocardialsignalnormal(心肌壁信號正常)Systolicfunctiondecreased(心臟收縮功能減弱)Atriumproblelyenlarged(心房擴大)DiagnosiscriterioninnerdiameterofLVinlastdiastolicphase>6cm(左室舒張末期內(nèi)徑≥6cm)

RestrictivecardiomyopathyDefinition:Increasedresistancetoventricularfillingduetoincreasedmyocardialstiffness

定義:在收縮容積正常或降低(單/雙心室)、舒張容積正?；蚪档鸵约笆冶诤穸日５那闆r下發(fā)生的限制性左室生理學異常。DiffuseinfiltrationofamyloidinamyloidosisPatchyinfiltrationofgranulomasinsarcoidosisExtensiveirondepositsinhemochromatosisMyocytehy