摘要
目的探讨利用3.0T磁共振电影成像及心肌钆延迟强化(LGE)技术检测存活心肌,评估冠状动脉慢性完全闭塞(CTO)行经皮冠状动脉介入术(PCI)患者术后心功能恢复情况。方法连续收集2017年12月至2019年12月就诊的CTO患者32例,所有患者在PCI术前及术后6个月行3.0T心脏磁共振检查,评估心脏结构、功能、心肌瘢痕范围、心肌活性等指标,比较PCI术前术后各相关指标的变化。结果CTO-PCI术后,虽然左室射血分数(LVEF)、左室舒张末内径(LVEDD)、左室收缩末期容积(LVESV)和左室舒张末期容积(LVEDV)均较术前有所改善,但差异无统计学意义(P>0.05)。延迟强化积分术后较术前改善不明显(P>0.05)。左室壁运动积分术后的(59.76±6.95)分较PCI术前的(65.23±7.24)分显著改善,差异有统计学意义(P<0.01)。结论CTO-PCI术前利用3.0T心脏磁共振检测存活心肌可为临床预后评估提供重要依据,非透壁性延迟强化(透壁程度<50%)患者的术后局部室壁运动可明显改善。
Objective To evaluate the recovery of cardiac function by 3.0 T cine-magnetic resonance imaging(cine-MRI)and late gadolinium enhancement(LGE)assessing viable myocardium in patients with chronic total occlusion(CTO)after percutaneous coronary intervention(PCI).Methods A total of 32 consecutive patients with CTO treated from December 2017 to December 2019 were selected and received cine-MRI before and 6 months after PCI to evaluate cardiac structure and function,myocardial scar,myocardial activity and other indicators.The changes of relevant indicators were observed and compared before and after PCI.Results After CTO-PCI,left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic volume(LVESV)and left ventricular end diastolic volume(LVEDV)were improved compared with those before operation,but there were no significant differences(P>0.05).The delayed-enhancement score was not obviously improved after PCI(P>0.05).The left ventricular wall motion score after PCI was significantly better than that before PCI(59.76±6.95 vs 65.23±7.24,P<0.01).Conclusion Detection of viable myocardium by 3.0 T cine-MRI before CTO-PCI can provide an important reference for clinical prognosis assessment,and the local ventricular wall motion can be significantly improved in patients with non-transmural delayed-enhancement(transmural extent<50%).
作者
张义
王万虹
崔文
李锦爽
丁浩
朱春侠
张荣林
ZHANG Yi;WANG Wan-hong;CUI Wen;LI Jin-shuang;DING Hao;ZHU Chun-xia;ZHANG Rong-lin(Department of Cardiology,Suqian People's Hospital of Nanjing Drum-Tower Hospital Group,Suqian,Jiangsu 223800,China)
出处
《中国临床研究》
CAS
2021年第3期299-303,共5页
Chinese Journal of Clinical Research
基金
江苏省“333高层次人才培养”工程项目(BRA2016259)。
关键词
心脏磁共振
电影成像
心肌钆延迟强化
慢性完全性闭塞
冠状动脉
存活心肌
Cardiac magnetic resonance
Cine-magnetic resonance imaging
Late gadolinium enhancement
Chronic total occlusion,coronary artery
Viable myocardium
