用磁共振成像评估左心室重建术后室壁同步化运动的变化  

Assessment of the Changes of Left Ventricular Synchrony after Left Ventricular Reconstruction Surgery with Magnetic Resonance Imaging

作　　者：樊红光[1] 凤玮[1] 郑哲[1] 张岩[2] 金利新 应癸 赵世华[2] 胡盛寿[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心 阜外心血管病医院心血管疾病国家重点实验室 外科,北京100037 [2]中国医学科学院北京协和医学院国家心血管病中心 阜外心血管病医院心血管疾病国家重点实验室 放射科,北京100037 [3]西门子有限公司(上海) 医疗系统集团科研协作组,上海200010 [4]清华大学生物医学工程系,北京100083

出　　处：《中国胸心血管外科临床杂志》2014年第2期168-173,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金："十二五"国家科技支撑计划资助项目(2011BAI11B21)~~

摘　　要：目的阐明急性心肌梗死后非梗死区心肌在手术前后的同步化状况。方法选取自2010年6月1日至2011年6月31日12例因心肌梗死后室壁瘤在北京阜外心血管病医院接受左心室重建术、合并心功能不全的患者为研究对象,其中男9例,女3例;年龄(53.9±7.0)岁。选取健康对照者12名,男10名、女2名,年龄(30.6±3.8)岁。用磁共振成像(MRI)检查2次,均加做tagging序列,用第三方软件同步相位软件(Harmonic Phase,HARP)进行数据抽取,再将其输入另一同步化指数计算软件计算同步化指数。结果左心室重建术后左心室射血分数由30.3%±7.7%升高至43.4%±6.3%(P<0.05),左心室收缩期末容积指数由(68.6±10.8)ml/m2缩小至(32.7±9.0)ml/m2(P<0.05)。然而,左心室非梗死区的同步化指数保持不变,从0.82±0.13到0.83±0.17(P>0.05)。结论左心室重建术可以提高左心室射血分数,明显缩小左心室容积,但对非心肌梗死区心肌的心肌同步化指数无明显影响。Objective To investigate dyssynchrony of non-infarction areas before and after surgical ventricular reconstruction after acute myocardial infarction. Methods Twelve patients with postinfarction ventricular aneurysm and heart failure who underwent left ventricular reconstruction surgery in Fu wai Hospital from June 1,2010 to June 31,2011 were enrolled in this study. There were 9 male and 3 female patients with their age of 53.9±7.0 years. Another 12 healthy volunteers were chosen as the control group including 10 males and 2 females with their age of 30.6±3.8 years. Magnetic resonance imaging （MRI） was examined preoperatively and within 3 months after discharge with same sequences. Tagging images were analysis by using Harmonic Phase （HARP） software to extract the data and the data were put into another software to calculate dyssynchrony index. Results After operation,left ventricular ejection fraction （LVEF） improved from 30.3 %± 7.7 % to 43.4%±6.3 % （P〈0.05）,and left ventricular end-systolic volume index decreased from 68.6±10.8 ml/m2 to 32.7±9.0 ml/m2 （P〈0.05）. However,left ventricular dyssynchrony index of non-infarction areas remained stablefrom 0.82±0.13 to 0.83±0.17 （P〉0.05）. Conclusion Surgical ventricular reconstruction can significantly improve LVEF and reduce left ventricular volume,but left ventricular synchrony index of non-infarction areas is not changed.

关 键 词：磁共振成像 室壁瘤 外科治疗 同步化 

分 类 号：R654.2[医药卫生—外科学]