心脏磁共振图像融合技术在评估急性心肌梗死中的应用价值  

Application Value of Cardiac Magnetic Resonance Image Fusion in the Evaluation of Acute Myocardial Infarction

作　　者：李子文 尹宏斌 张亚运 冯永丽 张子倩 周莹[1,3] LI Ziwen;YIN Hongbin;ZHANG Yayun(Lianyungang Clinical Medical College of Nanjing Medical University,Lianyungang,Jiangsu Province 222000,P.R.China)

机构地区：[1]南京医科大学连云港临床医学院,222000 [2]锦州医科大学连云港市培养基地,222000 [3]南京医科大学康达学院第一附属医院影像科,222000 [4]徐州医科大学附属连云港市第一人民医院,222000

出　　处：《临床放射学杂志》2023年第7期1108-1112,共5页Journal of Clinical Radiology

基　　金：中华国际医学交流基金会SKY影像科研基金项目(编号:Z-2014-07-2101)。

摘　　要：目的探讨心脏磁共振(CMR)图像融合技术在评估急性心肌梗死(AMI)中的应用价值。方法前瞻性纳入接受经皮冠状动脉介入治疗(PCI)和CMR检查的AMI患者52例,扫描方案包括扩散加权成像(DWI)、心脏电影成像及心肌延迟强化(LGE)成像,对心脏电影与DWI进行图像融合。以LGE为参考标准,比较心脏电影-DWI和DWI的AMI诊断效能、图像质量评分及测量AMI面积的准确性。结果DWI诊断AMI阳性率为92.3%,心脏电影-DWI诊断AMI阳性率为96.2%,两者无显著差异(P>0.05)。DWI与心脏电影-DWI的梗死心肌评分无显著差异(P>0.05),心脏电影-DWI的正常心肌评分和整体心肌评分高于DWI(P值均<0.01)。DWI测量的AMI面积稍大于LGE(P<0.01),心脏电影-DWI测量的AMI面积与LGE无显著差异(P>0.05)。DWI与LGE测量AMI面积的偏倚为4.1%,95%一致性界限为-5.0%~13.3%,相关性系数r为0.842(P<0.01)。心脏电影-DWI与LGE测量AMI面积的偏倚为0.5%,95%一致性界限为-4.6%~5.5%,相关性系数r为0.954(P<0.01)。结论基于心脏电影成像与DWI的图像融合技术较DWI能提高图像质量和测量AMI面积的准确性。Objective To investigate the application value of cardiac magnetic resonance(CMR)image fusion in the evaluation of acute myocardial infarction(AMI).Methods Fifty-two patients with AMI who underwent percutaneous coronary intervention(PCI)and CMR were prospectively enrolled.The scanning protocol included diffusion-weighted imaging(DWI),cardiac cine imaging and late gadolinium enhancement(LGE)imaging.Image fusion was performed on cardiac cine and DWI.Using LGE as the reference standard,the diagnostic efficiency,image quality score and accuracy of AMI area measurement were compared between cardiac cine-DWI and DWI.Results The AMI positive rate for DWI was 92.3%,and cardiac cine-DWI was 96.2%,there was no significant difference between them(P>0.05).There was no significant difference between DWI and cardiac cine-DWI myocardial infarction scores(P>0.05).Cardiac cine-DWI had higher normal and global myocardial scores than DWI(P<0.01).The AMI area measured using DWI was slightly larger than that using LGE(P<0.01),and there was no significant difference between AMI area measured using cardiac cine-DWI and LGE(P>0.05).The bias of AMI area measured using DWI and LGE was 4.1%.The 95%consistency range was-5.0%-13.3%,and the correlation coefficient r was 0.842(P<0.01).The bias of AMI area measured using cardiac cine-DWI and LGE was 0.5%.The 95%consistency limit was-4.6%-5.5%,and the correlation coefficient r was 0.954(P<0.01).Conclusion Compared with DWI,the image fusion technique based on cardiac cine imaging and DWI can improve the image quality and the accuracy of the AMI area measurement.

关 键 词：心脏磁共振 急性心肌梗死 扩散加权成像 融合图像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.22[医药卫生—诊断学]