대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제63권5호
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  • Pages.419-423
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  • 2010
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지

심부전 환자에서 발견된 좌심실 비치밀심근의 심장 자기공명영상과 경흉부 심초음파: 증례 보고

Cardiac MRI and Transthoracic Echocardiography of Left Ventricular Myocardial Noncompaction in A Patient with Congestive Heart Failure: A Case Report

  • 조의민 (조선대학교병원 영상의학과) ;
  • 변주남 (조선대학교병원 영상의학과) ;
  • 김동훈 (순천향대학교 부천병원 영상의학과)
  • Cho, Eui-Min (Department of Radiology, Chosun University Hospital) ;
  • Byun, Joo-Nam (Department of Radiology, Chosun University Hospital) ;
  • Kim, Dong-Hun (Department of Radiology, Soonchunhyang University Hospital Bucheon)
  • 투고 : 2010.05.09
  • 심사 : 2010.07.26
  • 발행 : 2010.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

호흡곤란을 주소로 내원한 38세 남자의 자기공명영상과 경흉부 심초음파를 이용하여 진단한 비치밀심근 증례를 보고하고자 한다. 자기공명영상과 경흉부 심초음파에 심실 첨부 전체벽, 심실 중간부 전벽과 하벽에 과도하게 돌출된 잔기둥과 좌심실 벽에 깊은 함요를 보였고, 이완기에 측정한 비치밀근과 치밀근의 비율(noncompaction/compaction ratio)이 2.5로 증가하였으며 좌심실 수축기 장애가 관찰되었다. 또한, 가돌리늄 조영제 주입 후 15분 지연 영상에서 심실 중간부 중격 전벽과 중격하벽에 경계가 불분명한 비정상적인 지연조영증강이 관찰되었다. 저자들은 심부전이 동반된 비치밀심근의 병리기전, 임상양상, 진단적 접근법에 대해 고찰하였다.

We report a case of a 38-year-old male presenting with new-onset dyspnea, that was diagnosed as left ventricular noncompaction by transthoracic echocardiographic and cardiac MR. The tests revealed left ventricular systolic dysfunction with prominent trabeculations associated with deep intertrabecular recesses and an enddiastolic noncompacted to compacted ratio of 2.5 in the whole apical wall and mid-ventricular anterolateral and inferolateral walls. Delayed gadolinium contrast-enhanced MRI revealed subepicardial mid-wall hyperenhancement of the midventricular anteroseptal and inferoseptal walls, which suggested myocardial fibrosis. We review the pathophysiology, clinical characteristics, and diagnostic approach of the left ventricular noncompaction associated with congestive heart failure.

키워드

참고문헌

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