心肌标记技术在心肌缺血中的应用价值  

An investigation on the clinical value of tagging magnetic resonance imaging in assessing myocardial ischemia

作　　者：侯洁[1] 肖俊睿 孙玉[1] 杨忠路[2] 周巍[1] 周姝[1] 王薇[1] 李军辉[1] 杨本强[1] HOU Jie;XIAO Junrui;SUN Yu;YANG Zhonglu;ZHOU Wei;ZHOU Shu;WANG Wei;LI Junhui;YANG Benqiang(Department of Radiology,General Hospital of Shenyang Military Region,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院放射诊断科,沈阳110016 [2]沈阳军区总医院心外科,沈阳110016

出　　处：《功能与分子医学影像学（电子版）》2018年第1期1360-1363,1369,共5页Functional and Molecular Medical Imaging(Electronic Edition)

基　　金：辽宁省国产医疗器械研发;评价与推广协同创新工程(2015305010);国家工信部;卫计委两部委课题(2016MHD110002002101)

摘　　要：目的探讨磁共振心肌标记技术在心肌缺血中的应用价值。方法结扎巴马小型猪冠状动脉法构建心肌缺血模型,并于建模前、建模后进行心脏磁共振心肌标记检查,分别由从事心血管磁共振诊断不同经验的甲乙两名医师对建模前、后心肌运动进行评分分类评估。结果建模前心肌标记图像示网格随心脏收缩舒张运动协调一致,甲乙两名主治医师对正常心肌运动评分分类结果高度一致(Kappa=0.768);建模4 w后心肌标记图像显示网格变形,网格运动失调或运动消失,甲乙两名主治医师对缺血心肌运动评分分类结果亦高度一致(Kappa=0.750)。4 w后心肌标记图像示运动不协调区域的病理表现为心肌细胞坏死、心肌纤维化等。结论心肌标记技术可有效显示心肌运动情况,并对运动进行分级,且受观察者经验的限制较小。Objective To evaluate the application value of tagging magnetic resonance imaging in assessing myocardial ischemia. Methods Myocardial ischemic model was made by ligating the left anterior descending artery of Bama mini-pigs. Tagging magnetic resonance imaging was performed before modeling and 4 weeks after the procedure. Two physicians, with different experience in CMR diagnosis, assessed the results of tagging CMR imaging. Results The tags before the procedure were consistent with the systolic and diastolic movement of the heart. The classification results of the normal myocardial motion score were consistent（Kappa = 00.768）. 4 week after the procedure, the imaging showed tags deformation, dyskinesia or disappearance of the movement. The classification results were also highly consistent（Kappa = 0.750）. The dyskinesia area in tagging showed myocardial necrosis and fibrosis by pathology. Conclusion Tagging CMR can effectively display myocardial motion and cliassify motion, and is not limited by the experience.

关 键 词：心肌标记 动物模型 心脏磁共振 心脏电影成像 心肌缺血 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]