磁共振心肌灌注成像预估急性心肌梗死疗效的临床研究  

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

作　　者：江利[1] 冯敢生[1] 孔祥泉[1] 肖学宏[2] 刘定西[1] 于群[1] 王朝晖[3] 王秋芬[3] 

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 [2]广东省中山市人民医院放射科 [3]华中科技大学同济医学院附属协和医院心内科

出　　处：《临床心血管病杂志》2001年第12期545-548,共4页Journal of Clinical Cardiology

摘　　要：目的 :采用磁共振 (MR)首过灌注成像分析急性心肌梗死 (AMI)心肌首过灌注特点 ,评价病变心肌组织血流灌注治疗效果。方法 :AMI患者 16例 ,正常对照组 8例。采用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 :AMI未溶栓者首过不强化 ,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 ,峰值信号强度仅为正常心肌的 (5 4 .5± 12 .0 ) %。溶栓再灌注者首过及延迟均强化 ,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 ,峰值信号强度可达正常心肌的 (90 .8±13.0 ) %。结论 :TurboFLASH序列可反映心肌首过灌注 ,分析心肌首过灌注有助于评价病变心肌血流灌注情况 。Objective:To evaluate thrombolytic effect on acute myocardial infarction using first pass MR.Method:Turbo FLASH were performed on 16 patients to study first pass myocardial perfusion. Signal intensity time curve were drawn for analyzing.Result:Hypoenhancement on first pass and hyperenhancement on delay phase appeared in patients who didn′t receive thrombolysis therapy. There were significant differences between the time of upslope, the rate of upslope, peak time of the signal intensity time curves and contrast enhancement ratio of ischemic myocardium and normal myocardium. The peak signal intensity of ischemic myocardium was ( 54.5 ± 12.0 )% of normal. Hyperenhancement appeared on first pass and delay phase in revascularized patients receiving thrombolysis therapy. Only the time of upslope prolonged. And the peak signal intensity of ischemic myocardium was ( 90.8 ± 13.0 )% of normal. Conclusion:Myocardial first pass perfusion reflects the blood supply of the myocardium. To analyze the first pass porfusion is helpful to assess blood supply of the damaged myocardium, and to evaluate the effect of thrombolysis therapy.

关 键 词：心肌梗死 磁共振成像 首过心肌灌注成像 

分 类 号：R542.22[医药卫生—心血管疾病]