比较小剂量多巴酚丁胺负荷MRI和延迟强化MRI预测陈旧心肌梗死心功能恢复的价值  

Comparative Study on Low Dose Dobutamine Stress and Delayed Contrast--Enhanced MRI in Predicting Functional Recovery of Chronic Myocardial Infarction

作　　者：贺毅[1] 张兆琪[1] 董继伟[1] 于薇[1] 赵轶轲[1] 晏子旭[1] 

机构地区：[1]首都医科大学附属北京安贞医院磁共振室,北京100029

出　　处：《实用放射学杂志》2010年第6期827-830,共4页Journal of Practical Radiology

摘　　要：目的 比较小剂量多巴酚丁胺负荷MRI和延迟强化MRI预测陈旧心肌梗死心功能恢复价值.方法 10例陈旧心肌梗死病人于10 d内行小剂量多巴酚丁胺负荷（5～10 μg·kg-1·min-1）心脏电影MRI和延迟强化心脏MRI,所有病人均行血运重建术, 3～6月后再次行静息MRI心脏电影检查评价心功能恢复情况.结果 10例患者中38个心肌节段室壁运动异常,其中24个节段血运重建后功能恢复,14个节段功能未恢复.小剂量多巴酚丁胺负荷MRI和延迟强化MRI预测心功能恢复的敏感性、特异性、准确性分别为95.7% vs 85.7%（P=0.094＞0.05）、85.7%vs 78.5% （P=0.50＞0.05）、 92.1% vs 78.9%.ROC曲线下面积小剂量多巴酚丁胺负荷MRI和延迟强化MRI分别为0.91和0.79.结论 小剂量多巴酚丁胺负荷MRI与延迟强化MRI预测陈旧心肌梗死心功能恢复诊断能力相当.Objective To study the diagnostic value of low dose dobutamine stress and delayed enhancement MRI in predicting functional recovery of chronic myocardial infarction. Methods Low dose dobutamine （ 5-10μg·kg^-1·min^-1 ） stress cine-MRI and delayed contrast-enhanced MRI were performed in 10 patients with chronic myocardial infarction. All patients underwent successful revascularization and another rest cine-MRI（ 3-6 months after revascularization）study to assess segmental myocardial functional recovery. Results 38 myocardial segments showed having myocardial wall motion abnormalities in 10 patients, of which, 24 segments showed functional recovery and 14 segments remained dysfunction 3-6 months after revascularization. The sensitivity and specificity in predicting functional recovery by low dose dobutamine stress and delayed enhancement MRI were 95.7% and 85.7% （P =0. 094〉0.05） ,85.7%and 78.5%（P=0.50〉0.05） ,respectively. The areas under the ROC were 0.91 at dobutamine cine- MRI and 0.79 at late enhancement MRI. Conclusion The ability in predicting functional recovery of chronic myocardial infarction is similar with both low close dobutamine stress and delayed enhancement MRI.

关 键 词：心脏 磁共振成像 心肌梗死 

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