急性心肌梗死MR心肌灌注成像实验及临床应用研究  

Assessment of myocardial perfusion using Gd-DTPA enhanced first-pass MRI in patients and animals with acute myocardial infarction

作　　者：江利[1] 冯敢生[1] 孔祥泉[1] 吴汉平[1] 肖学宏[1] 刘定西[1] 于群[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉研究生430022

出　　处：《中华放射学杂志》2001年第7期499-503,共5页Chinese Journal of Radiology

摘　　要：目的　采用MR首过灌注成像评价急性心肌梗死心肌组织血流灌注特点及治疗效果。方法　急性心肌梗死模型犬 9条 ,对照组犬 4条 ;心肌梗死患者 16例 ,正常对照组 8例。采用磁化准备梯度回波 (turboFLASH)序列行MR首过灌注及延迟成像扫描 ,绘制左心室各壁心肌信号强度 时间曲线 ,分析病变心肌信号强度 时间曲线特点。结果　心肌梗死模型犬及未溶栓治疗组心肌首过呈低强化 ,延迟扫描信号强度高于正常心肌 ,曲线上升时间、上升斜率、峰值时间和对比增强率明显低于正常心肌。心肌梗死溶栓再灌注组首过及延迟均强化 ,延迟扫描时病变心肌信号强度高于正常心肌 ,信号强度 时间曲线仅曲线上升时间延长。心肌梗死模型犬和未溶栓治疗组病变心肌峰值信号强度较正常心肌明显降低 ,分别为正常心肌的 (4 4 8± 13 0 ) %和 (5 4 5± 12 0 ) % ,溶栓再灌注组病变心肌峰值信号强度可达正常心肌的 (90 8± 13 0 ) %。结论　turboFLASHMR心肌首过灌注成像有助于评价心肌血流灌注及溶栓疗效。Objective To evaluate the characteristics of myocardial perfusion and therapeutic effect of acute myocardial infarction using first pass perfusion MR imaging. Methods With turbo fast low angle shot(turbo FLASH) sequence, Gd DTPA enhanced first pass myocardial perfusion and delayed imagings were performed on 16 patients, 9 infarcted canines and 8 healthy volunteers. Signal intensity time curves of left ventricle walls were drawn and analyzed. Results Hypoenhancement on first pass and hyperenhancement on delayed phase appeared in patients who didn′t receive thrombolysis therapy and infarcted canines. There were significant differences of the time of upslope, the upslope, peak time of the signal intensity time curves and contrast enhancement ratio between ischemic myocardium and normal. Hyperenhancement appeared on first pass and delay phase in revascularizative patients receiving thrombolysis therapy with prolonged time of upslope. The peak signal intensity of ischemic myocardium in infarcted canines and non thrombolysis patients and revascularizative patients were (44.8±13 0)%, (54.5±12 0)% and (90.8±13 0)% of that of normal. Conclusion Gd DTPA enhanced first pass myocardial perfusion MRI is helpful to assess blood supply of infarcted myocardium and the effect of thrombolysis therapy.

关 键 词：急性心肌梗死 磁共振血管造影 心肌灌注成像 实验研究 

分 类 号：R542.22[医药卫生—心血管疾病]