The relative atrial volume ratio and late gadolinium enhancement provide additive information to differentiate constrictive pericarditis from restrictive cardiomyopathy

Journal of Cardiovascular Magnetic Resonance

Research

Zuoxiang He¹  Shiliang Jiang²  Jian Ling²  Qiong Liu²  Ning Ma²  Shihua Zhao²  Chaowu Yan²  Yan Zhang²  Huaibing Cheng²  Minjie Lu²  Gang Yin²  Renate Jerecic³ 

[1] Department of Nuclear medicine, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, PR, China;Department of Radiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, PR, China;MR Research and Development, Siemens Medical Solutions USA, Inc., Chicago, IL, USA;

关键词: Cardiovascular Magnetic Resonance;    Late Gadolinium Enhancement;    Left Atrial;    Left Atrial Volume;    Constrictive Pericarditis;   

DOI  :  10.1186/1532-429X-13-15

 received in 2010-09-02, accepted in 2011-02-25,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe differentiation of constrictive pericarditis (CP) from restrictive cariomyopathy (RCM) is often difficult. This study sought to determine the clinical utility of cardiovascular magnetic resonance imaging (CMR) for differentiating both these disorders.MethodsTwenty-three patients with surgically documented CP, 22 patients with RCM and 25 normal subjects were included in the study. CMR yielded information about cardiac morphology, function and tissue characteristics. The left (LA) and right atrial (RA) volume was calculated using the area-length method. The relative atrial volume ratio (RAR) was defined as the LA volume divided by RA volume. Receiver operating characteristic curve analysis was used to test the ability of different variables in differentiating CP from RCM.ResultsThe maximal pericardial thickness in CP patients was significantly larger than in normal subjects and RCM patients. The RA volume index in RCM patients (90.5 ± 35.3 mL/m2) was significantly larger than in CP patients (71.4 ± 15.7 mL/m2, p = 0.006) and normal subjects (38.1 ± 9.0 mL/m2, p < 0.001). The LA volume index in RCM (96.0 ± 37.0 mL/m2) and CP patients (105.6 ± 25.1 mL/m2) was significantly larger than in normal subjects (39.5 ± 9.5 mL/m2, p < 0.001 for all). The RAR in CP patients (1.50 ± 0.29) was significantly larger than in RCM patients (1.12 ± 0.33, p < 0.001) and normal subjects (1.06 ± 0.20, p < 0.001). There were no differences between RCM patients and normal subjects in the RAR (p = 0.452). At a cut-off value of 1.32 for the RAR, the sensitivity was 82.6%, and the specificity was 86.4% in the detection of CP. Septal bounce was identified in 95.7% CP patients, in none of RCM patients and normal subjects. Late gadolinium enhancement (LGE) was present in 31.8% RCM patients and absence in all CP patients and normal subjects.ConclusionsCMR with LGE and RAR can facilitate differentiation of CP from RCM.

【 授权许可】

Unknown   
© Cheng et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.