Der dicke linke Ventrikel: Ursachen und Differenzialdiagnose der linksventrikulären Hypertrophie und Implikationen für die kardiovaskuläre Radiologie

Zusammenfassung

Verdickte linke Ventrikelwände sind ein häufiger Befund, der echokardiografisch, computertomografisch und kernspintomografisch zuverlässig nachgewiesen werden kann. Zu den häufigen Ursachen zählen alle Erkrankungen, die mit einer Nachlasterhöhung einhergehen, sowie primäre und sekundäre Kardiomyopathien. Durch die Möglichkeit, sowohl funktionelle Parameter des linken Ventrikels als auch die myokardiale Masse exakt zu bestimmen und gleichzeitig strukturelle Veränderungen des Herzmuskels nachzuweisen, ist die kardiale MRT die beste bildgebende Methode zur Quantifizierung der linksventrikulären Hypertrophie, zur Abklärung der Ursache und zur Charakterisierung der myokardialen Veränderungen. Bei der kardialen MRT ist hierzu jedoch ein flexibles, an die individuellen Befunde angepasstes Untersuchungsprotokoll erforderlich. In dieser Übersichtsarbeit werden die unterschiedlichen zugrunde liegenden Erkrankungen ausführlich beschrieben und sinnvolle diagnostische Algorithmen bei Patienten mit linksventrikulärer Hypertrophie vorgestellt.

Abstract

Hypertrophy of the left ventricular myocardium is a common finding and can be reliably detected by echocardiography, CT and MRI. Common causes include diseases associated with increased cardiac afterload as well as primary and secondary cardiomyopathy. With the opportunity to determine functional parameters and myocardial mass precisely as well as to detect structural changes of the cardiac muscle simultaneously, cardiac MRI is the most precise imaging method for quantifying left ventricular hypertrophy as well as determining the cause and the exact characterization of the myocardial changes. It is mandatory, however, to create a flexible, individually adapted examination protocol. This review presents useful diagnostic algorithms in relation to different underlying pathologies in patients with left ventricular hypertrophy.

Key words

heart - MR imaging - hyperplasia/hypertrophy

• Literatur

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