MR心脏增强诊断心梗后室壁瘤的应用价值  

Application value of MR cardiac enhancement in diagnosis of ventricular wall tumor after myocardial infarction

作　　者：杨慧[1] 王坤 杨瑞[1] 刘继伟[1] YANG Hui;WANG Kun;YANG Rui;LIU Jiwei(Medical Imaging Department,Henan Chest Hospital(Chest Hospital of Zhengzhou University),Zhengzhou 450008,Henan,China;Department of Cardiology,Henan Chest Hospital(Chest Hospital of Zhengzhou University),Zhengzhou 450008,Henan,China)

机构地区：[1]河南省胸科医院(郑州大学附属胸科医院)医学影像科,河南郑州450008 [2]河南省胸科医院(郑州大学附属胸科医院)心内科,河南郑州450008

出　　处：《中国医学工程》2023年第5期36-40,共5页China Medical Engineering

摘　　要：目的分析成人心梗后左心室室壁瘤(LVA)的MR影像学特点及临床应用价值。方法回顾性分析河南省胸科医院2019年5月至2022年5月27例心梗后左室室壁瘤患者的MR影像表现,分析总结MR心脏增强对心梗后室壁瘤的诊断价值。结果27例中真性LVA 20例,假性LVA 7例;MR诊断真、假室壁瘤灵敏度、特异度及准确率均明显高于彩超及DSA检查,附壁血栓及矛盾运动区域检出率同样高于彩超及DSA检查(P<0.05)。MR心脏增强检查还能精确判断早期室壁瘤局部残存活性心肌范围及损害程度。结论MR心脏增强检查诊断室壁瘤具有较高的灵敏度、特异度及准确率;其特异性影像学表现是其它检查所不具备的,对于急性期室壁瘤临床血管再活化及恢复微循环治疗前评估存活心肌及了解病变范围,提供可靠的证据。【Objective】To analyze MR imaging characteristics of left ventricular aneurysm(LVA)after adult myocardial infarction.【Methods】The MR imaging findings of 27 adult patients from May 2019 to May 2022 were analyzed,and the diagnostic value of cardiac MR enhancement was summarized.【Results】In 27 cases,20 were true LVA and 7 were false LVA.The sensitivity,specificity and accuracy of MR diagnosis of true and pseudotumor were significantly higher than that of color ultrasound and DSA,and the detection rate of mural-thrombus and contradictory movement area was also higher than color ultrasound and DSA(P<0.05),it was also statistically significant.Myocardial resting perfusion imaging:ventricular perfusion reduction or defect in the diseased area;myocardial delayed reinforcement imaging:delayed enhancement or incomplete myocardial enhancement throughout the whole area;decreased island myocardial resting perfusion in the same area,and salvage residual active myocardium often occurs in the early stage of ventricular aneurysm formation.【Conclusion】Cardiac MR enhancement examination has high sensitivity,specificity and accuracy,and its specific imaging performance is not available in other examinations,which provides reliable evidence for the evaluation of the surviving myocardium and the understanding of the lesion range before the clinical vascular reactivation and the recovery of microcirculation treatment.

关 键 词：收缩期增厚率 矛盾运动 室壁瘤 MR心脏增强 

分 类 号：R542.22[医药卫生—心血管疾病]