摘要
目的探讨心脏磁共振成像（MRI）首过灌注与延迟增强在急性心肌梗死（AMI）中的临床应用,评估其对AMI心肌缺血程度判定的价值。方法采用西门子AVANTO（1.5T）MR扫描仪对2013年8月至2015年7月该院收治的25例AMI患者行MR电影成像,接着静脉注入对比剂钆喷酸葡胺（Gd-DTPA）及生理盐水,采用tflsr1924sliPAT序列行首过灌注扫描。再次团注半剂量Gd-DTPA及生理盐水,等待5-10 min,行TI-scout扫描以确定最佳TI值,最后以序列tfipsirsingle-short10sl、tfl25t1psirsegmented延迟扫描,评价每例患者的梗死部位、梗死心肌质量（IM）、梗死百分比（PSI）、射血分数（EF）、左室功能参数及透壁程度。结果 25例患者心肌梗死均显示清晰,梗死灶首过灌注为充盈缺损,延迟为高信号的强化区。其中16例为透壁心肌梗死,9例为非透壁心肌梗死。IM平均为（11.2±7.8）g,PSI平均为（8.9±7.3）%,EF平均为（53.5±16.8）%。结论心脏MRI首过灌注与延迟增强应用于AMI患者,可准确判断心肌缺血程度和范围,对于临床诊治及预后判断具有较高的指导价值。
Objective To investigate the clinical application of cardiac MRI first-pass perfusion and delayed enhance ment in acute myocardial infarction（AMI） and to assess its value in judging AMI myocardial ischemia degree. Methods The Siemens AVANTO（1.5 T） MR scanner was adopted to conduct the MRI film imaging in 25 cases of AMI in our hospital from Au-gust 2013 to July 2015,then the contrast agent Gd-diethylenetriamine pentaacetic acid（Gd-DTPA） and normal saline were intravenously injected,tflsr1924sli PAT sequence was adopted to conduct the first-pass perfusion scan. Bolus injection of half dose of Gd-DTPA and normal saline were performed again,waiting for 5-10 min,the TI-scout scan was conducted to determine the best value of TI,and finally the delay scan was performed by the sequence tfipsirsingle-short10sl,tfl25t1psirsegment ed. The infarction position,quality of infarction myocardium（IM）,infarct percentage（PSI）,left ventricular function parameters and through wall degree were evaluated in each case. Results The myocardial infarction in 25 cases was clearly displayed. The first-pass perfusion of infarction lesion was filling defect,delay was the strengthening area of high signal. Among them,16 cases were through wall myocardial infarction and 9 cases were non-through wall myocardial infarction. IM averaged（11.2±7.8）g,PSI averaged（8.9±7.3）%,the average ejection fraction was（53.5±16.8）%. Conclusion Applying MRI first-pass perfusion and delayed enhancement in AMI patients can accurately judge the degree and range of myocardial ischemia and has higher guidance value for its clinical treatment and prognosis judgment.
出处
《现代医药卫生》
2016年第9期1305-1307,共3页
Journal of Modern Medicine & Health
基金
重庆市科委基础与前沿研究计划项目(cstc2014jcyj A10120)
重庆市卫计委医学科研计划项目(2012-2-187
20142089)
关键词
磁共振成像
心肌梗死
心肌再灌注
延迟增强
心肌缺血
Magnetic resonance imaging
Myocardial infarction
Myocardial reperfusion
Delayed enhancement
Myocardial ischemia
