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心肌灌注MRI和MR电影在急性冠状动脉综合征中的应用 被引量:19

Evaluation the role of myocardial perfusion of MRI and MR cine in acute coronary syndrome
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摘要 目的 评估心肌灌注MRI和MR电影在急性冠状动脉 (简称冠脉 )综合征中的应用价值。方法 急性冠状动脉综合征患者 5 5例 ,再灌注治疗 3~ 6个月后 ,进行心脏MR影像检查。真正快速稳态梯度序列 (FIESTA)用于观察心肌运动 ;快速梯度回波序列 (FGREET)用于观察首过时相心肌灌注的MRI特征 ;反转恢复梯度回波序列 (MDE)用于观察延迟时相心肌灌注MRI特征。结果5 5例中 38例患者可见位于心内膜下心肌的首过灌注缺损 ,其信号强度相对值显著低于周围心肌。心肌灌注延迟时相MRI示 5 1例患者心室壁内存在不同范围的强化灶 ,其信号强度值是周围心肌的4 36倍 (t=1.6 9,P <0 .0 5 )。心室壁内所存在的延迟强化灶范围和信号均匀程度与心室壁运动能力显著相关 (非标准相关系数分别为 - 4 2 195、- 10 1 75 0 ,标准相关系数分别为 - 0 377、0 4 2 5 ;t分别为- 5 735、- 5 4 4 5 ,P值均 <0 .0 0 1)。结论 梗死心肌于MR心肌灌注延迟时相呈现显著强化。通过综合分析延迟强化 ,运动能力显著降低和可能存在的首过灌注缺损 ,可以更有效地识别梗死 (或瘢痕 ) Objective To evaluate the role of comprehensive cardiac MRI (CMRI) in diagnosis of patients with coronary artery disease (CAD) Methods 55 patients with acute coronary syndrome underwent MR imaging 3-6 months after the reperfusion therapy Short axis images acquired by cine FIESTA sequence were used to analyze the motion of the different anatomy regions Used the FGRE ET sequence to detect the patterns of the first pass perfusion after injection of 0 2 mmol·kg 1 Gd DTPA at a flow of 3 ml·s 1 7-12 min later, MDE pulse sequence used to recognize the high signal in the myocardium Results At study entry, 38 subjects had the defect in the first pass perfusion The signal in the defect was significantly lower than that in the normal regions, which always in the subendocardium 51 subjects had delayed enhancement regions in the myocardium at different degree and different range The mean intensity of hyperenhanced regions was 4 36 times higher compared with that of the regions without hyperenhancement The difference between the 2 regions had statistical significance The extent of hyperenhancement was significantly related to the abnormality of wall motion The range of delayed enhancement was bigger than that of the first perfusion defect Conclusion Comprehensive evidence of delayed hyperenhancement, dysfunction of myocardium, and the defect of first pass perfusion can be used to predict myocardial infarction
出处 《中华放射学杂志》 CAS CSCD 北大核心 2002年第8期702-706,共5页 Chinese Journal of Radiology
关键词 急性冠状动脉综合征 诊断 心肌灌注 MR电影 磁共振成像 Coronary disease Myocardial reperfusion Myocardial infarction Magnetic resonance imaging
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