钆布醇在心肌梗死伴心力衰竭患者磁共振延迟增强成像中的应用  

Gadobutrol in Late Gadolinium Enhancement Magnetic Resonance Imaging on Myocardial Infarction Patients with Heart Failure

作　　者：申晓俊 陈铟铟 恽虹 赵士海 葛梅英 曾蒙苏 梁宗辉[2] 金航 SHEN Xiaojun;CHEN Yinyin;YUN Hong(Department of Radiology,Zhongshan Hospital,Fudan University and Shanghai Institute of Medical Imaging,Shanghai 200032,P.R.China)

机构地区：[1]复旦大学附属中山医院放射科,上海市影像医学研究所,上海200032 [2]复旦大学附属静安区中心医院放射科,上海200040

出　　处：《临床放射学杂志》2024年第4期538-542,共5页Journal of Clinical Radiology

基　　金：上海市卫生健康委员会科研课题(编号:202040349);上海市静安区医学科研课题青年项目(编号:2022QN03)。

摘　　要：目的 比较单倍剂量钆布醇和单倍剂量钆喷酸葡胺在心肌梗死伴心力衰竭患者心脏磁共振延迟增强成像中显示梗死心肌的差异。方法 前瞻性纳入42例有心肌梗死病史合并心力衰竭患者行心脏磁共振延迟增强成像扫描,根据对比剂类型将患者随机分为A组(钆喷酸葡胺)和B组(钆布醇)。最终40例患者的心脏磁共振延迟增强图像用于数据分析:A组20例,B组20例。延迟增强图像分别于注射对比剂后5~8 min、9~12 min及13~16 min时完成。比较两组对比剂之间左心室血池的信噪比(SNR_(LV))、梗死心肌的信噪比(SNR_(IM))、梗死心肌和正常心肌之间的对比噪声比(CNR_(IM-RM))及梗死心肌和左心室血池之间的对比噪声比(CNR_(IM-LV));比较同一组对比剂在三个时间段内左心室梗死心肌体积的差异。结果 5~8 min时,两组对比剂在SNR_(IM)、SNR_(LV)、CNR_(IM-RM)和CNR_(IM-LV)之间的差异均无统计学意义(P>0.05),且SNR_(IM)、SNR_(LV)在同一组对比剂内无显著差异(P>0.05);此时无法准确测量左心室梗死心肌体积。9~12 min和13~16 min时,两组对比剂的SNR_(IM)均显著高于SNR_(LV)(P<0.05),B组的SNR_(IM)、SNR_(LV)、CNR_(IM-RM)和CNR_(IM-LV)均显著高于A组(P<0.05)。在这两个时间段内,左心室梗死心肌体积在同一组对比剂内差异无统计学意义(P>0.05)。结论 由心肌梗死所致心力衰竭患者在延迟时间为9~12 min、13~16 min行心脏磁共振延迟增强扫描时,单倍剂量钆布醇较单倍剂量钆喷酸葡胺可更好地显示、评估梗死心肌的程度。Objective To compare single⁃dose gadobutrol with single⁃dose gadopentetate dimeglumine in the cardiac late gadolinium enhancement magnetic resonance imaging(MRI)on heart failure patients to examine infarcted myocardi⁃um.Methods A prospective selection of 42 myocardial infarction patients with heart failure who had undergo cardiac late gadolinium enhancement MRI were randomly divided into two groups according to different type of contrast agents:group A(gadopentetate dimeglumine)and group B(gadobutrol).Finally,cardiac magnetic resonance images of 40 patients were used for data analysis:20 in group A and 20 in group B.Following the administration,the late gadolinium enhancement ima⁃ges were acquired 5-8 mins,9-12 mins and 13-16 mins later,respectively.Comparisons were drawn between the two contrast agents in terms of the signal⁃to⁃noise ratio(SNR)of infarcted myocardium(SNR_(IM)),SNR of the left ventricular blood pool(SNR_(LV)),and contrast⁃of⁃noise ratio(CNR)between the infarcted myocardium and remote myocardium(CNR_(IM-RM))and CNR between the infarcted myocardium and left ventricular blood pool(CNR_(IM)⁃LV).The difference in vol⁃ume of the total left ventricular infarcted myocardium at the three time intervals was compared within the same group.Re⁃sults At 5-8 mins,no significant difference was found between the two groups in SNR_(IM),SNR_(LV),CNR_(IM-RM) and CNR_(IM)⁃LV(P>0.05),the first two being having no significantly different within the same group(P>0.05).The volume of the total left ventricular infarcted myocardium cannot be accurately measured.At 9-12 mins and 13-16 mins,respectively,SNR_(IM) was found to be significantly higher than SNR_(LV) both in two groups.Of note was the evidence that the SNR_(IM),SNR_(LV),CNR_(IM-RM) and CNR_(IM)⁃LV were significantly higher in group B than in group A(P<0.05).The volume of the total left ven⁃tricular infarcted myocardium at these two time intervals within the same group were no significant difference(P>0.05).Conclusion Single⁃dose gado

关 键 词：心力衰竭 梗死心肌 磁共振成像 钆布醇 钆喷酸葡胺 

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] R541.6[医药卫生—临床医学]