心肌梗死MRI与病理性Q波的相关性研究  

The Relationship between MRI and Pathological Q Wave of Myocardial Infarction

作　　者：张青[1] 王振常[1] 鲜军舫[1] 田其昌[1] 赵波[1] 吴超[1] 张华[1] 史旭波[2] 李田昌[2] 

机构地区：[1]首都医科大学北京同仁医院影像中心,北京100730 [2]首都医科大学北京同仁医院心血管中心,北京100730

出　　处：《实用放射学杂志》2008年第7期892-895,共4页Journal of Practical Radiology

摘　　要：目的探讨陈旧心肌梗死的MRI评定参数与心电图的病理性Q波及SelvesterQRS评分的相关性。方法对32例陈旧心肌梗死患者行心脏MRI检查，采用1．5T磁共振扫描仪。行心电门控的FIESTA心脏电影MRI后，以4ml／s的速率静脉注射Gd—DTPA0．1mmol／kg后立即行首过灌注成像，随后以2．5ml／s的速率静脉注射Gd—DTPA0．1mmol／kg，延迟5～10min后行延迟强化成像。评价每名患者的梗死质量、梗死百分比、左室功能；分析心电图的病理性Q波，并进行SelvesterQRS评分。结果梗死质量平均为（14．8±11．4）g，梗死百分比平均为（12．7±8．4）％，两者分别与Q波心梗、SelvesterQRS分数、左室功能（LVESV、LVES—VI、LVEDV、LVEDVI、LVEF）、室壁运动异常、灌注缺损段数相关（P〈0．05）。结论决定Q波／非Q波心梗的主要因素为梗死质量。SelvesterQRS分数是反映陈旧心肌梗死大小及左室功能的较好指标。Objective To study the relationship between magnetic resonance imaging（ MRI） assessment of myocardial infarction and pathological Q wave of electrocardiogram（ ECG） and Selvester QRS scoring. Methods 32 patients with first chronic myocardial infarction （ MI） underwent cine MRI at a 1.5 Tesla system. Then a first - pass perfusion scan was acquired simultaneously with the administration of Gd -DTPA at a dose of 0.1 mmol/kg body weight. Following with a second bolus of 0.1 mmol/kg body weight,myocardial delayed enhance- ment （ MDE） was performed 5 to 10 minutes later. Infarction mass （ IM） , percentage size of infarction（ PSI） , transmural extent and left ven- tricle （ LV） functons were determined for each patient. The 12 - lead ECG was analysed for pathological Q - waves, and complete 54 - crite- ria 32 - point Selvester QRS score system was applied to evaluate the infarct size. Results The mean IM was （ 14.8 ± 11.4 1 g , and the mean PSI was （ 12.7± 8.4）% , these two parameters were correlated with Q waves MI （ QWMI） , Selvester QRS scoring, left functions （LVESV, LVESVI, LVEDV, LVEDVI, LVEF） , wall motion abnormality （WMA） and perfusion defect segments （PDS）, respectively（P 〈 0.05 ）. Conclusion The key to determine QWMI / NQWMI is IM. Selvester QRS scoring is one of the good parameters reflecting the size of the chronic MI and LV functions.

关 键 词：心肌梗死 磁共振成像 心电图 Selvester QRS评分 

分 类 号：R542.22[医药卫生—心血管疾病] R445.2[医药卫生—内科学]