左室短长轴观在心肌梗塞MRI诊断中的价值  

The Value of the Short and Longaxis Sections of LV on the MRI Diagnosis of Myocardial Infarction

作　　者：杨岳松[1,2] 李建奇[1,2] 许群[1,2] 林祺 诸慧铭[1,2] 汪守中[1,2] 

机构地区：[1]上海市第一人民医院MRI室 [2]福建龙岩地区第一医院MRI室

出　　处：《临床放射学杂志》1998年第1期30-32,共3页Journal of Clinical Radiology

摘　　要：目的：确定左心室短长轴观在心肌梗塞ＭＲＩ诊断中的价值。材料与方法：对２２例不同时期心肌梗塞患者（急性期１例、亚急性期５例和慢性期１６例）采用与室间隔垂直和平行的左室短长轴观进行ＳＥ和ＣｉｎｅＭＲＩ检查，８例同时行左室短轴多相多层ＳＥ检查。着重分析短长轴观左室梗塞节段分布和运动情况，并与心电图和心超结果对照。结果：左室短轴观可清楚显示数目最多的室壁节段，包括前壁、间隔壁、外侧壁、后壁和下壁，但心尖节段显示不如长轴观；垂直于室间隔的左室长轴观能较好显示外侧壁、心尖和间隔壁；平行于室间隔的左室长轴观可较好显示下壁、心尖、后壁和前壁。２２例心梗节段分布ＭＲＩ所见与ＥＣＧ吻合：前壁１４例（同时累及间壁５例，同时累及下壁３例）；后壁４例；下壁和外侧壁各２例。采用左室短长轴观的ＣｉｎｅＭＲＩ发现梗塞室壁节段运动大致正常３例，减弱１１例，消失５例和呈矛盾运动２例。８例多相多层ＳＥ和１０例心超对照所见与ＣｉｎｅＭＲＩ一致。结论：采用垂直和平行于心脏纵轴的左室短长轴观ＳＥ和ＣｉｎｅＭＲＩ能完整显示室壁诸节段，利于心肌梗塞的形态学和运动功能评价。Objective: To determine the value of the short and longaxis sections of left ventricle on the MRI diagnosis of myocardial infarction.Materials and Methods:Twentytwo patients with different stages of myocardial infarction (MI) including 1 acute MI, 5 subacute MI and 16 chronic MI were evaluated by SE and Cine MRI techniques using the short and longaxis sections perpendicular and parallel to interventricular septum. On acquired short and longaxis MRI images the distribution of the involved LV segments and their wall motion abnormalities were analyzed and compared with results of ECG and echocardiography.Results:The shortaxis images of LV could demonstrate the involved segments such as anterior, septum, latertal and the inferior wall very well, but the apical segment could not be shown clearly as on the longaxis images of LV on which the inferior, posterior, anterior and septum wall could be demonstrated. The MRI demonstration of the involved segments in 22 patients with MI was correlated closely with results suggested by ECG findings and among them were 14 involved the anterior wall with 5 involving the septum and 3 involving the inferior wall simultaneously, 4 involved the posterior wall and 2 involved the inferior and the lateral wall separately. The infarcted wall motion were depicted as 3 normal, 11 hypokinetic, 5 akinetic and 2 dyskinetic on the short and longaxis images of LV obtained by using Cine MRI techniques, which showed a high agreement on the evaluation of the involved segments by using multiplephase multipleplanar SE technique in 8 cases and by using echocardiography in 10 cases.Conclusion: The whole segments of LV wall could be demonstrated well on the short and longaxis sections of LV using SE and Cine MRI techniques and that could be beneficial to the showing of the morphology of LV and the evaluation of the wall motion abnormalities.

关 键 词：磁共振成像 成像平面 心肌梗塞 左室短长轴观 

分 类 号：R542.220.4[医药卫生—心血管疾病] R445.2[医药卫生—内科学]