多巴酚丁胺负荷磁共振成像检测存活心肌的临床研究  

Value of low dose dobutamine magnetic resonance imaging in assessment of viable myocardium

作　　者：郝骥[1,2] 祁春梅[1,2] 武维恒[1,2] 蔡文标[1,2] 冯建启[1,2] 刁军[1,2] 吴浩[1,2] 

机构地区：[1]徐州矿务集团总医院 [2]徐州医学院第二附属医院心内科,江苏徐州221000

出　　处：《临床荟萃》2010年第22期1936-1938,共3页Clinical Focus

摘　　要：目的评价小剂量多巴酚丁胺(10μg.kg-1.min-1)负荷磁共振成像(MRI)检测存活心肌的临床价值。方法经彩色多普勒超声检查存在左心室壁节段运动障碍冠心病患者24例,进行MRI、小剂量多巴酚丁胺负荷MRI、冠状动脉造影(CAG)及经皮冠状动脉介入治疗(PCI),所有狭窄病变行完全血运重建。参照美国超声心动图学会16节段划分法,经MRI测得各运动异常节段小剂量多巴酚丁胺负荷前后舒张末期室壁厚度(EDWT),以应用小剂量多巴酚丁胺后室壁增厚为存活心肌标准;术后1、3、6个月时复查心脏超声,以冠状动脉血运重建后室壁节段收缩功能改善为判断存活心肌的金标准。结果 24例冠心病患者共获得符合条件的室壁运动异常节段170个,根据金标准判断其中115个为存活心肌,55个为非存活心肌;MRI检测存活心肌的敏感度、特异度、准确度分别是76.5%、90.9%、81.2%。结论小剂量多巴酚丁胺负荷MRI检测存活心肌有较高的临床价值。Objective This study was to evaluate the value of low dose dobutamine stress（10 μg·kg^-1·min^-1） magnetic resonance imaging（MRI） in the detection of viable myocardium.Methods Twenty-four hospitalized patients with regional wall motion abnormalities（RWMA） according to routine echocardiography underwent MRI,low dose dobutamine stress MRI,coronary angiography and percutaneous coronary intervention（PCI）.End-diastolic wall thickness（EDWT） of every left ventricular myocardial segment image according to 16-segment models of American Society of Echocardiography was acquired through MRI.Those segments whose EDWT got thicker after low dose dobutamine stress were regarded viable myocardium.The motion of every segment was observed by echocardiography after 1,3,6 months.The gold standard of viable myocardium was the ventricular segments whose motion got better after PCI was regarded viable myocardium.Results In all 170 segments acquired there were 115 viable myocardium segments and 55 non-viable myocardium segments according to gold standard.The sensitivity,specificity,and accuracy of MRI in detecting viable myocardium were 76.5%,90.9%,81.2%,respectively.Conclusion Low dose dobutamine stress MRI can be used as a valuable measure to detect viable myocardium in the patients with coronary artery disease.

关 键 词：冠状动脉疾病 磁共振成像 组织存活 多巴酚丁胺 

分 类 号：R541.4[医药卫生—心血管疾病]