以急性冠脉综合症为临床表现的心肌炎MRI影像特征研究  

作　　者：张晓茹 陈晓荣 华崇俊 潘江峰 

机构地区：[1]浙江大学医学院附属金华医院,321000

出　　处：《浙江临床医学》2023年第12期1847-1849,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省金华市中心医院中青年科研启动基金项目(JY2020-2-07)。

摘　　要：目的探讨以急性冠脉综合症为临床表现的心肌炎患者的心脏磁共振(CMR)表现特征。方法回顾性收集2019年1月至2023年3月本院以急性冠脉综合症为临床表现的心肌炎患者49例作为观察组,并收集同期心电图无异常的心肌炎患者40例作为对照组,均有CMR检查资料。观察第1~16节段心肌受累情况,进行左心室功能及容积分析,计算左室射血分数(LVEF)及容积参数,测量横向驰豫加权成像(T_(2)WI)、早期强化(EGE)及延迟强化(LGE)受累心肌及正常心肌信号强度(SI),计算受累心肌与正常心肌的信号强度(SI)比值,分析比较观察组及对照组各参数。结果观察组最常累及心肌第4、13节段,各累及21个节段,对照最常累及心肌第3节段,共累及16个节段;观察组与对照组比较,LVEF下降、收缩末期容积(ESV)及收缩末期容积指数(ESVi)增大,差异有统计学意义(P<0.05);观察组T_(2)WI受累心肌SI及T_(2)WI、早期强化、延迟强化受累心肌与正常心肌的SI比值较对照组大,差异有统计学意义(P<0.05)。结论以急性冠脉综合症为临床表现的心肌炎患者具有相对特异的CMR表现。Objective To investigate characteristics of cardiac magnetic resonance imaging(CMR)in myocarditis patients with acute coronary syndrome as the clinical manifestation.Methods 49 myocarditis patients with acute coronary syndrome as the clinical manifestation in Jinhua Central Hospital from January 2019 to March 2023 were retrospectively collected as the case group,and 40 myocarditis patients without abnormal electrocardiogram were collected as the control group.All patients had date of CMR.The myocardial involvement of the 1st to 16th segments were observed.The left ventricular function and volume analysis was performed,the LVEF and volume parameters were calculated.The affected myocardium and normal myocardium signal intensity(SI)I n transverse relaxation weighted imaging(T_(2)WI),early-gadolinium enhancement(EGE)and late-gadolinium enhancement(LGE)were measured,and the signal intensity(SI)ratio of the affected myocardium and normal myocardium were calculated.The parameters of the case group and the control group were analyzed and compared.Results The 4th and 13th segments of the myocardium were most frequently involved in the case group(21 each),and the 3rd segment of the myocardium was most frequently involved in the control group(16).LVEF in the case group were decreased than that in the control group,ESV and ESVi were increased,and the difference was statistically significant(P<0.05).The SI of the involved myocardium on T_(2)WI and the SI ratio on T_(2)WI,EGE,and LGE in the case group were larger than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Myocarditis Patients with acute coronary syndrome as the clinical manifestation have relatively specific cardiac magnetic resonance findings.

关 键 词：心脏磁共振成像 心肌炎 急性冠脉综合症 心室功能 

分 类 号：R541.4[医药卫生—心血管疾病] R542.21[医药卫生—内科学] R445.2[医药卫生—临床医学]