ARTICLE

Volume 4,Issue 9

Cite this article
5
Citations
20
Views
20 September 2026

肥厚型心肌病心脏磁共振成像诊断新进展

景 邓1 ,  紫薇 刘1 ,  嘉帅 李1 ,  忠祥 朱1
Show Less
1 武汉市普仁医院, 中国
MRP 2026 , 4(9), 46–50; https://doi.org/10.61369/MRP.2026090024
© 2026 by the Author(s). Licensee Art and Technology, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

肥厚型心肌病是以左心室心肌非对称性肥厚为典型特征的常见遗传性心肌病,也是青少年及运动员心源性猝死的重要原因,而心脏磁共振成像由于具有极佳的软组织分辨力及多参数成像能力,故已被公认为肥厚型心肌病(HCM)诊断、鉴别诊断及危险分层的重要检查工具。本文总结了近年来心脏磁共振(CMR)在肥厚型心肌病诊疗中的最新进展,讨论晚期钆增强、T1 mapping 及细胞外容积分数等(ECV)定量技术在心肌纤维化定量、疾病亚型细分及心源性猝死风险预测诸方面的关键作用,最后分析HCM 人工智能辅助诊断的前沿方向。

Keywords
肥厚型心肌病
心脏磁共振
晚期钆增强
T1 mapping
心肌纤维化
危险分
References

[1] Ramchand J, Fava AM, Chetrit M, et al.Advanced imaging for risk stratification of sudden death in hypertrophic cardiomyopathy[J]. Heart. 2020;106(11):793-801.
[2] Files Flores R, Mané F, Antunes N, et al. Apical hypertrophic cardiomyopathy, are low-risk patients really at low risk? A case report[J]. Eur Heart J Case
Rep. 2020;4(5):1-4. Published 2020 Oct.
[3] Ito T, Suwa M. Echocardiographic tissue imaging evaluation of myocardial characteristics and function in cardiomyopathies[J]. Heart Fail Rev. 2021;26(4):813-828.
[4] Lewicka-Potocka Z, Dąbrowska-Kugacka A, Lewicka E, et al. The “athlete’s heart” features in amateur male marathon runners[J]. Cardiol J. 2021;28(5):707-715.
[5] 李志明, 韩丹, 杞天付, 等. 心脏磁共振T1mapping 技术评估肥厚型心肌病心肌纤维化[J]. 中国医学影像学杂志, 2022,30(4):341-347.
[6] 姚岗, 卢嘉翰, 张强. 心脏MR T1 mapping 技术对肥厚型心肌病心肌纤维化的诊断价值[J]. 川北医学院学报, 2023,38(9):1232-1235.
[7] Li Y, Liu X, Yang F, et al. Prognostic value of myocardial extracellular volume fraction evaluation based on cardiac magnetic resonance T1 mapping with T1 long and short
in hypertrophic cardiomyopathy[J]. Eur Radiol. 2021;31(7):4557-4567.
[8] 梁学恒, 高世平, 石思玮. 心脏MR T1 mapping 技术在肥厚型心肌病与高血压性心脏病的诊断价值[J]. 实用放射学杂志, 2023,39(4):566-570.
[9] Shi RY, Wu R, An DL, et al. Texture analysis applied in T1 maps and extracellular volume obtained using cardiac MRI in the diagnosis of hypertrophic cardiomyopathy
and hypertensive heart disease compared with normal controls[J]. Clin Radiol. 2021;76(3):236.e9-236.e19.
[10] Greulich S, Seitz A, Herter D, et al. Long-term risk of sudden cardiac death in hypertrophic cardiomyopathy: a cardiac magnetic resonance outcome study[J]. Eur Heart
J Cardiovasc Imaging. 2021;22(7):732-741.
[11] Yang Y, Yin G, Jiang Y, et al. Quantification of left atrial function in patients with non-obstructive hypertrophic cardiomyopathy by cardiovascular magnetic resonance
feature tracking imaging: a feasibility and reproducibility study[J]. J Cardiovasc Magn Reson. 2020;22(1):1.
[12] Śpiewak M, Kłopotowski M, Mazurkiewicz Ł, et al. Predictors of right ventricular function and size in patients with hypertrophic cardiomyopathy[J]. Sci
Rep. 2020;10(1):21054.
[13] 李雪菲, 焦凤辉, 王桂东, 等. 心脏磁共振成像在HCM 诊断及预后评估中的应用[J]. 中国CT 和MRI 杂志, 2025,23(1):89-91.
[14] 苏瑾, 朱永胜, 罗秀霞, 等. 心脏磁共振和超声诊断肥厚性心肌病的价值[J]. 影像诊断与介入放射学, 2020,29(3):167-170.
[15] Grant MD, Mann RD, Kristenson SD, et al. Transthoracic Echocardiography: Beginner’s Guide with Emphasis on Blind Spots as Identified with CT and MRI[J].
Radiographics. 2021 Jul-Aug;41(4):1022-1042.
[16] 王晓琰, 肖华, 郭久红, 等. 磁共振成像在心尖肥厚型心肌病中的诊断价值[J]. 分子影像学杂志, 2019,42(1):1-4.
[17] 卢拥华, 徐细平, 曾知恒. 心肌致密化不全的诊断与鉴别诊断[J]. 右江民族医学院学报, 2010,32(6):853-855.
[18] Li X, Shi K, Yang ZG, et al. Assessing right ventricular deformation in hypertrophic cardiomyopathy patients with preserved right ventricular ejection fraction: a 3.0-T
cardiovascular magnetic resonance study[J]. Sci Rep. 2020;10(1):1967.
[19] Ding W, Bhushan S, Ma C, et al. Right Ventricle Involvement in Hypertrophic Cardiomyopathy and Role of Cardiac Magnetic Resonance in Hypertrophic Cardiomyopathy:
Review Article[J]. Heart Surg Forum. 2021;24(4):E746-E750.
[20] 于建才, 刘永兴, 袁永刚, 等. 心脏磁共振诊断梗阻性肥厚型心肌病1 例[J]. 医学影像学杂志, 2019,29(4):536,552.
[21] 和燕斐, 葛红, 杨瑞, 等. 心脏磁共振对梗阻性肥厚型心肌病化学消融术后的随访价值[J]. 河南医学高等专科学校学报, 2022,34(4):416-420.
[22] Palmisano V, Cossa S, Esposito A, et al. Obstructive and Nonobstructive Hypertrophic Cardiomyopathy: Differences in Global and Segmental Myocardial Strain by
Cardiac Magnetic Resonance Feature Tracking[J]. J Thorac Imaging. 2022;37(1):49-57.
[23] Farrag NA, Lochbihler A, White JA, et al.Evaluation of fully automated myocardial segmentation techniques in native and contrast-enhanced T1-mapping cardiovascular
magnetic resonance images using fully convolutional neural networks[J]. Med Phys. 2021;48(1):215-226.
[24] Vanmali A, Alhumaid W, White JA. Cardiovascular Magnetic Resonance-Based Tissue Characterization in Patients With Hypertrophic Cardiomyopathy[J]. Can J Cardiol.
2024;40(5):887-898.
[25] Rowin EJ, Schulz A. Role of cardiac magnetic resonance imaging in the management of hypertrophic cardiomyopathy[J]. Indian J Thorac Cardiovasc Surg. 2026;42(2):168-
180.
[26] Nakamori S, Rowin EJ, Rodriguez J, et al. Accelerated myocardial fibrosis in young to middle-aged patients with hypertrophic cardiomyopathy[J]. J Cardiovasc Magn
Reson. 2024;26(2):101072.
[27] Markousis-Mavrogenis G, Giannakopoulou A, Belegrinos A, et al. Cardiovascular Magnetic Resonance Imaging Patterns in Rare Cardiovascular Diseases[J]. J Clin Med.
2022;11(21).
临床研究 | CLINICAL RESEARCH
050 | Copyright © This Work is Licensed under A Commons Attribution-Non Commercial 4.0 International License.
[28] Yang Z, Yao FY, Long YT, et al. Association between cardiac dysfunction and late gadolinium enhancement confined to the LV intramural region in patients with
hypertrophic cardiomyopathy[J]. Ann Med. 2025;57(1):2533425.
[29] Zhi Y, Zhang TY, Gui FD, et al. Myocardial Fibrosis Evaluated by T1 Mapping and Its Relationship to Left Ventricular Hypertrophy, Strain, and T2 Value in
Hypertrophic Cardiomyopathy Without Late Gadolinium Enhancement[J]. J Thorac Imaging. . Published online Oct 14,2025. doi:10.1097/RTI.0000000000000862.
[30] Mancio J, Pashakhanloo F, El-Rewaidy H, et al. Machine learning phenotyping of scarred myocardium from cine in hypertrophic cardiomyopathy[J]. Eur Heart J
Cardiovasc Imaging. 2022;23(4):532-542.
[31] Fahmy AS, Rowin EJ, Arafati A, et al. Radiomics and deep learning for myocardial scar screening in hypertrophic cardiomyopathy[J]. J Cardiovasc Magn Reson.
2022;24(1):40.
[32] Huang S, Shi K, Zhang Y, et al. Texture analysis of T2-weighted cardiovascular magnetic resonance imaging to discriminate between cardiac amyloidosis and
hypertrophic cardiomyopathy[J]. BMC Cardiovasc Disord. 2022;22(1):235.
[33] 官乐, 林辉, 赵振华, 等. 心脏磁共振影像组学对肥厚性心肌病的诊断和预测价值[J]. 全科医学临床与教育, 2024,22(3):256-259.
[34] Zhang H, Tian J, Zhang C, et al. Discrimination models with radiomics features derived from cardiovascular magnetic resonance images for distinguishing hypertensive
heart disease from hypertrophic cardiomyopathy[J]. Cardiovasc Diagn Ther. 2024;14(1):129-142.
[35] Zhou H, Li L, Liu Z, et al. Deep learning algorithm to improve hypertrophic cardiomyopathy mutation prediction using cardiac cine images[J]. Eur Radiol.
2021;31(6):3931-3940.
[36] Sahota M, Saraskani SR, Xu H, et al. Machine learning evaluation of LV outflow obstruction in hypertrophic cardiomyopathy using three-chamber cardiovascular
magnetic resonance[J]. Int J Cardiovasc Imaging. 2022;38(12):2695-2705.
[37] Kim EK, Lee SC, Chang SA, et al. Prevalence and clinical significance of cardiovascular magnetic resonance adenosine stress-induced myocardial perfusion defect in
hypertrophic cardiomyopathy[J]. J Cardiovasc Magn Reson. 2020;22(1):30.
[38] 喻诗琴, 杨凯, 赵世华. 单纯心尖肥厚型心肌病进展为中部梗阻并室壁瘤形成1 例[J]. 中华心血管病杂志[J], 2024,52(1):79-81.
[39] Sharka I, Panichella G, Grigoratos C, et al. Myocardial Perfusion Imaging with Cardiovascular Magnetic Resonance in Nonischemic Cardiomyopathies: An In-Depth
Review of Techniques and Clinical Applications[J]. Medicina (Kaunas). 2025;61(5).
[40] Ku MC, Kober F, Lai YC, et al. Cardiovascular magnetic resonance detects microvascular dysfunction in a mouse model of hypertrophic cardiomyopathy[J]. J Cardiovasc
Magn Reson. 2021;23(1):63.
[41] Tanigaki T, Kato S, Azuma M, Ito M, Horita N, Utsunomiya D. Coronary flow reserve evaluated by phase-contrast cine cardiovascular magnetic resonance imaging of
coronary sinus: a meta-analysis[J]. J Cardiovasc Magn Reson. 2023;25(1):11.
[42] Schulz A, Wallace TE, Chow K, et al. Quantitative myocardial blood flow and perfusion reserve with exercise cardiovascular magnetic resonance[J]. J Cardiovasc Magn
Reson. 2025 Winter;27(2):101988.
[43] Huurman R, van der Velde N, Schinkel AFL, et al. Contemporary family screening in hypertrophic cardiomyopathy: the role of cardiovascular magnetic resonance[J]. Eur
Heart J Cardiovasc Imaging. 2022;23(9):1144-1154.
[44] Joy G, Lopes LR, Webber M, et al. Electrophysiological Characterization of Subclinical and Overt Hypertrophic Cardiomyopathy by Magnetic Resonance Imaging-Guided
Electrocardiography[J]. J Am Coll Cardiol. 2024;83(11):1042-1055.
[45] 李元程, 王杰, 陈玉成. 肥厚型心肌病基因型与磁共振表型的关联性研究进展[J]. 心血管病学进展, 2019,40(2):157-161.

Share
Back to top