| 高 超,杨丽萍,王可铮,曹绍东.心脏磁共振成像评价缺血性心肌病的临床应用价值[J].,2018,(22):4374-4377 |
| 心脏磁共振成像评价缺血性心肌病的临床应用价值 |
| Value of Cardiac MRI for Assessment of Ischemic Cardiomyopathy |
| 投稿时间：2018-08-08 修订日期：2018-08-31 |
| DOI：10.13241/j.cnki.pmb.2018.22.040 |
| 中文关键词: 缺血性心肌病 磁共振成像 心肌功能 心肌灌注 心肌活性 |
| 英文关键词: Ischemic cardiomyopathy Magnetic resonance imaging Myocardial function Myocardial perfusion Myocardial viability |
| 基金项目:国家自然科学基金面上项目（81571740）；国家自然科学基金青年项目（81101086）；黑龙江省自然科学基金留学归国人员科学基金项目 (LC201436)；黑龙江省博士后启动基金项目（2018019） |
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| 中文摘要: |
| 摘要 目的：评估心脏磁共振（cardiac magnetic resonance,CMR）功能成像在缺血性心肌病临床诊断中的价值。方法：使用飞利浦3.0T磁共振仪，对32例临床确诊的缺血性心肌病患者进行CMR平扫及钆对比剂动态增强扫描。应用 Cardiac MR Analysis软件进行相关后处理分析，计算左室射血分数、室壁增厚率等心功能参数并与超声心动图检查结果相比较。采用17节段分段法分析心脏形态学、心肌组织运动、局部灌注、延迟增强等特点，评价其临床应用价值。结果：所有患者的心功能参数均降低，包括左室射血分数、每搏输出量、心输出量和室壁增厚率，心脏磁共振和超声心动图的测量结果并无明显差异(49%±5.3% vs 52% ± 8.2%; 42.8 mL± 8.9 mLvs 45.7 mL ± 10.6 mL; 3.5 L/min± 0.6 L/min vs 3.8 L/min± 0.9 L/min; 28%± 4%. vs 31% ±6%) (P >0.05)。所有患者中存在室壁运动异常的为184段(184/544)；其中心肌血流灌注信号减低的有136段(136/184)，呈现心肌延迟强化的有98段(98/136)。结论：CMR功能成像对于缺血性心肌病的临床诊疗及预后评估可提供与心肌形态及功能相关的重要信息。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinic value of cardiac magnetic resonance (CMR) in diagnosis of ischemic cardiomyopathy. Methods: Thirty-two patients diagnosed ischemic cardiomyopathy clinically underwent MRI plain scan and Gd-DTPA dynamic enhancement scan. The results were analysed by cardiac post-processing software, cardiac functional parameters such as left ventricular ejection fraction were calculated. Cardiac morphology, motion, perfusion and delayed -enhancement were analysed to assess its clinical application value. Results: Cardiac functional parameters of all patients were decreased, including left ventricular ejection fraction, stroke volume, cardiac output and wall thickening rate. There was no significant difference between cardiac magnetic resonance and echocardiography (49%±5.3% vs 52% ± 8.2%; 42.8 mL ± 8.9 mL vs 45.7 mL ± 10.6 mL; 3.5 L /min± 0.6 L/min vs 3.8 L/min± 0.9 L/min; 28%± 4%. vs 31% ±6%, P >0.05). 184 segments (184/544) showed abnormal wall motion in all patients, among these segments, the segments of signal decreasing and delayed-enhancement were136 and 98 respectively. Conclusion: Multimodality CMR provides important information of myocardial morphology and function in diagnosis and prognosis evaluation for ischemic cardiomyopathy. |
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