文章摘要
心脏磁共振成像评价缺血性心肌病的临床应用价值
Clinic application value of cardiac MRI in assessment of ischemic cardiomyopathy
投稿时间:2018-08-08  修订日期:2018-08-29
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基金项目:国家自然基金面上项目(81571740);国家自然基金青年项目(81101086);黑龙江省自然科学基金留学归国人员科学基金 (LC201436);黑龙江省博士后启动基金(2018019)
作者单位E-mail
高超 哈尔滨医科大学附属第四医院 352072293@qq.com 
杨丽萍   
王可铮   
△ 曹绍东   
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中文摘要:
      【】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%; 42.8ml ± 8.9ml vs 45.7ml ± 10.6ml; 3.5L /min± 0.6 L/min vs 3.8L/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功能成像可提供与心肌形态及功能相关的解剖学、血流动力学、细胞生物活性等方面的重要信息,对于缺血性心肌病的临床诊疗及预后评估意义重大。
英文摘要:
      【】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. Result :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%; 42.8ml ± 8.9ml vs 45.7ml ± 10.6ml; 3.5L /min± 0.6 L/min vs 3.8L/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 MRI scanning can provide important information about anatomy, hemodynamic, myocardial viability related to myocardial morphology and function ,which is of great significance to clinical dignosis and prognosis evaluation in ischemic cardiomyopathy.
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