陈旧性心肌梗死体积与左心功能相关性的MRI研究  

MRI study on the relationship between old myocardial infarction volume and left cardiac function

作　　者：吕璐璐[1] 徐鹏 马喜娟[1] 师毅冰[1] 徐凯 胡春峰 Lv Lulu;Xu Peng;Ma Xijuan;Shi Yibing;Xu Kai;Hu Chunfeng(Division of CT/MRI,Xuzhou Central Hospital,Xuzhou,221009,China)

机构地区：[1]江苏省徐州市中心医院CT/MRI室,江苏徐州221009 [2]徐州医科大学附属医院影像科,江苏徐州221002

出　　处：《中国中西医结合影像学杂志》2019年第1期27-30,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：徐州市中心医院创新团队基金项目(XZS201606)

摘　　要：目的:评价MRI心肌灌注及电影成像在陈旧性心肌梗死及左心功能评价中的应用价值。方法:33例诊断为陈旧性心肌梗死的患者(病变组),均行心脏MRI灌注及电影成像。分析左心室室壁运动、心肌灌注首过期和延迟期MRI特征,确定梗死心肌的程度及范围。分析梗死心肌体积与室壁运动、左室功能的相关性。选取25例正常体检者作为对照组,评价病变组与对照组心脏形态与功能。结果:33例病变组中32例(97.0%)延迟期心肌可见高信号,其中20例(60.6%)首过期灌注减低,12例(36.4%)无灌注减低;1例(3.0%)首过期灌注减低且延迟期无心肌强化。延迟期心肌强化阳性率与首过期灌注减低率差异无统计学意义(χ2=0.589,P>0.05)。病变组梗死心肌体积平均值为(22.1±12.3)cm3,与射血分数呈负相关(r=-0.78,P<0.05),与左室室壁运动异常、左室舒张末期容积、收缩末期容积呈正相关(r=0.76、0.68、0.72,均P<0.05),与每搏输出量无明显相关性(r=0.23,P>0.05)。病变组左室长轴径、短轴径、左室舒张末期容积均较对照组增大,左室射血分数减小(P<0.05)。结论:MRI心肌灌注及电影序列可有效评价陈旧性心肌梗死程度和范围,且心肌梗死体积与室壁运动异常、左室功能相关。Objective:To evaluate the value of MRI myocardial perfusion and film imaging in old myocardial infarction and left heart function.Methods:33 patients with old myocardial infarction as observation group were performed MRI scan including perfusion and film imaging.The motion of left ventricular wall,the characteristics of first-pass perfusion and delayed enhanced cardiac MRI to define extent and scope of the infarcted myocardium were analyzed.The correlation between infarcted myocardial volume and wall motion and left ventricular function was analyzed.Another 25 healthy persons were selected as the control group.And the morphology and function of hearts were compared between the two groups.Results:In observation group,32 cases(97.0%)revealed delay hyperenhancement,incuding 20 cases(60.6%)showed hypoenhancement during the first-pass perfusion,12 cases(36.4%)without first-pass perfusion reduction;1 case(3.0%)showed hypoenhancement during the first-pass perfusion but with no delay enhancement.The positive rate of the delay enhanced period was higher than that of first-pass time,but the difference was no significant(χ2=0.589,P >0.05).The average myocardiac infarction volume was(22.1±12.3)cm3,had a negative correlation with LVEF(r=-0.73,P<0.05),had a positive correlation with WMA、EDV、ESV(r=0.76,0.68,0.72,respectively,all P<0.05),had no correlation with SV(r=0.23,P >0.05).Long shaft diameter,short shaft diameter,EDV of left ventricular in observation group were higher than that of control group,but EF was lower(all P<0.05).Conclusion:MRI myocardial perfusion and film imaging can effectively evaluate the extent of old myocardial infarction.The volume of myocardial infarction is related to wall motion and left ventricular function.

关 键 词：磁共振成像 心肌梗塞 心室功能 左 

分 类 号：R542.22[医药卫生—心血管疾病]