Advanced Method of the Contrast-Enhanced Cardiac Magnetic Resonance Imaging in the Diagnosis of Left Ventricular Papillary Muscles Scarring

The aim of the study was to assess the opportunities and improve contrast-enhanced cardiac magnetic resonance imaging in the diagnosis of left ventricular papillary muscles scarring. Materials and methods. Contrast-enhanced cardiac magnetic resonance imaging was performed 68 patients after myocardial infarction. The advanced method uses short signal inversion time (150-180 ms) to increase the contrast of myocardial scar in the papillary muscles. Results. The signs of papillary muscles scarring were identified in 16 patients (23,5%) by advanced method and in 12 patient (17.6%) by standard method. The signs of mitral insufficiency was found only in 9 patients (13.2%) by echocardiography. Conlusion. Found that contrast-enhanced cardiac magnetic resonance imaging allows to visualize morphological changes in a papillary muscles before violation of their function and mitral insufficiency development. Using short signal inversion time (150-180ms) allows increase by 3.5 times the contrast of myocardial scar in the papillary muscles.

магнитно-резонансная томография, контрастное усиление, ишемическая болезнь сердца, папиллярные мышцы, постинфарктный кардиосклероз, отсроченное контрастирование, время инверсии сигнала, conbast-enhanced cardiac magnetic resonance imaging, coronary artery disease, papillary muscles, scarring, late enhancement, inversion time

1. Уйманова Ю.К. Динамика ишемической митральной регургитации после операции аортокоронарного шунтирования: Автореф. дис.. канд. мед. наук. Л., 1996. 24 с.

2. Ахундов Р.Н. Мониторинг гемодинамики при хирургической коррекции ишемической митральной регургитации: Автореф. дис.. канд. мед. наук. М., 2012. 24 с.

3. Бокерия Л.А., Скопин И.И., Мироненко В.А. Хирургическое лечение ишемической митральной недостаточности. М.: Изд-во НЦССХ им. А.Н. Бакулева РАМН, 2003. 152 с.

4. Gillinov A.M., Wierup P.N., Blackstone E.H. et al. Is repair preferable to replacement for ischemic mitral regurgitation? J. Thorac. Cardiovasc. Surg. 2001; 122 (6): 1125-1141.

5. Di Donato M., Frigiola A., Menicanti L. et al. Moderate ischemic mitral regurgitation and coronary artery bypass surgery: effect of mitral repair on clinical outcome. J. Heart Valve Dis. 2003; 12 (3): 272-279.

6. Митьков В.В., Сандриков В.А. Клиническое руководство по ультразвуковой диагностике. М.: Видар, 1998. 360 с.

7. Фейгенбаум X. Эхокардиография. М.: Видар, 1999. 512 с.

8. Шиллер Н., Осипов М.А. Клиническая эхокардиография. М.: Практика, 2005. 344 с.

9. Лишманов Ю.Б., Чернов В.И. Сцинтиграфия миокарда в ядерной кардиологии. Томск: Изд-во ТГУ, 1997. 276 с.

10. Шумаков В.И., Остроумов Е.Н. Радионуклидные методы диагностики в клинике ИБС и трансплантации сердца. М.: Дрофа, 2003. 224 с.

11. Florian A., Jurcut R., Ginghina C., Bogaert J. Cardiac magnetic resonance imaging in ischemic heart disease: a clinical review. J. Med. Life. 2011; 4 (4): 330-345.

12. Стукалова О.В. Магнитно-резонансная томография сердца с отсроченным контрастированием - новый метод диагностики заболеваний сердца. Рос. электрон. журн. луч. диагн. 2013; 3 (1): 7-17.

13. Ahmed N., Carrick D., Layland J. et al. The role of cardiac magnetic resonance imaging (MRI) in acute myocardial infarction (AMI). Heart Lung Circ. 2013; 22 (4): 243-255.

14. La Gerche A., Claessen G., Van de Bruaene A. et al. Cardiac MRI: a new gold standard for ventricular volume quantification during high-intensity exercise. Circ. Cardiovasc. Imaging. 2013; 6 (2): 329-338.

15. Chuang M.L., Gona P., Hautvast G.L. et al. Correlation of trabeculae and papillary muscles with clinical and cardiac characteristics and impact on CMR measures of LV anatomy and function. J. Am. Coll. Cfrdiol. Cardiovasc. Imaging. 2012; 5 (11): 1115-1123.

16. Jaspers K., Freling H.G., van Wijk K. et al. Improving the reproducibility of MR-derived left ventricular volume and function measurements with a semi-automatic threshold-based segmentation algorithm. Int. J. Cardiovasc. Imaging. 2013; 29 (3): 617-623.

17. Okayama S., Uemura S., Soeda T. et al. Clinical significance of papillary muscle late enhancement detected via cardiac magnetic resonance imaging in patients with single old myocardial infarction. Int. J. Cardiol. 2011; 146 (1): 73-79.

18. Yang Y., Connelly K., Graham J.J. et al. Papillary muscle involvement in myocardial infarction: initial results using multicontrast late-enhancement MRI. J. Magn. Reson. Imaging. 2011; 33 (1): 211-216.