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[Characterization of hypertrophic cardiomyopathy with magnetic resonance]
E Di Cesare1, L Marsili, A Chichiarelli
1Cattedra di Radiologia, Università di L'Aquila.
Insights
Magnetic Resonance Imaging (MRI) effectively differentiates hypertrophic cardiomyopathy (HCM) from secondary myocardial hypertrophy (SMH). MRI reveals significant differences in myocardial signal intensity between HCM and SMH, aiding in diagnosis.
Area of Science:
- Cardiology
- Medical Imaging
- Biophysics
Background:
- Hypertrophic cardiomyopathy (HCM) is a primary cardiac condition.
- Secondary myocardial hypertrophy (SMH) results from other conditions.
- Differentiating HCM from SMH is crucial for appropriate patient management.
Purpose of the Study:
- To evaluate the utility of Magnetic Resonance Imaging (MRI) in distinguishing between hypertrophic cardiomyopathy (HCM) and secondary myocardial hypertrophy (SMH).
- To correlate MRI findings with echocardiography measurements in patients with myocardial hypertrophy.
- To analyze myocardial signal intensity differences using MRI in HCM versus SMH.
Main Methods:
- Utilized gated T1- and T2-weighted spin echo sequences and cine MRI for 15 HCM and 5 SMH patients.
- Correlated echocardiographic and MRI measurements for wall thickness and chamber dimensions.
- Analyzed myocardial signal intensity and performed t-tests to compare HCM and SMH groups.
Main Results:
- Strong correlations (R=0.72-0.89) were found between MRI and echocardiography measurements.
- Cine MRI identified systolic signal loss in the outflow tract of 9 obstructive HCM patients.
- Significant differences in myocardial signal intensity (T1 and T2 weighted) were observed between HCM and SMH patients (p < 0.01 and p < 0.04).
Conclusions:
- MRI is a valuable tool for differentiating HCM from SMH.
- MRI provides accurate measurements of myocardial hypertrophy, correlating well with echocardiography.
- Distinct MRI signal characteristics can help distinguish between primary and secondary myocardial hypertrophy.
Abstract:
We selected 15 patients with hypertrophic cardiomyopathy (HCM) and 5 with secondary myocardial hypertrophy (SMH). All patients were examined by means of Magnetic Resonance Imaging (MRI) and echocardiography. The MR study was performed with gated T1- and T2-weighted spin echo sequences and cine MRI. We correlated echocardiographic and MRI measurements and found a correlation coefficient (R) of 0.72 for apex thickness, r = 0.84 for posterior wall thickness, 0.76 for the lateral wall and 0.89 for the area at papillary level. Cine MR acquisitions showed signal loss in the systolic phase at the outflow tract in 9 obstructive HCM patients, which was consistent with echocardiographic color Doppler findings. The signal intensity of myocardial tissue was analyzed with MRI. The values were correlated with those of the skeletal muscle. We performed the paired sample t-test on T1- and T2-weighted spin echo sequences between the signal at the septum and that of the free wall in the 15 HCM patients. The analysis showed significant differences on T2-weighted sequences (p < 0.02). Unpaired t-test was performed between the 15 HCM and the 5 SMH patients; the analysis showed significant differences on both T1- (p < 0.01) and T2-weighted sequences (p < 0.04).