CMR心肌灌注成像参数在CHD患者微循环梗阻中的预测价值分析  

Predictive Value Analysis of CMR Myocardial Perfusion Imaging Parameters in Microcirculatory Obstruction of CHD Patients

作　　者：郑幼榕 薛秋榕 黄文镇 沈晓燕 陈鸿燕 ZHENG You-rong;XUE Qiu-rong;HUANG Wen-zhen;SHEN Xiao-yan;CHEN Hong-yan(Medical Imaging Department of Zhangzhou Hospital,Fujian Zhangzhou 363000;Catheter Room of Zhangzhou Hospital,Fujian Zhangzhou 363000)

机构地区：[1]漳州市医院医学影像科,福建漳州363000 [2]漳州市医院导管室,福建漳州363000

出　　处：《中国医疗器械信息》2025年第4期14-17,共4页China Medical Device Information

摘　　要：目的:探究心脏磁共振(CMR)心肌灌注成像参数在冠心病(CHD)患者微循环梗阻中的预测价值。方法:回顾性分析漳州市医院2021年1月~2023年12月收治的120例CHD患者临床资料。所有患者均在数字减影血管造影(DSA)下行经皮冠状动脉介入(PCI)术治疗,按照是否出现冠状动脉微循环梗阻(MVO)分为MVO组(n=35)及无MVO组(n=85)。对比两组各项基线资料,CMR心肌灌注成像参数。采用多因素Logistic回归分析CHD患者PCI术后MVO与影像因素的关系。通过受试者工作特征(ROC)曲线明确各项CMR心肌灌注成像参数预测CHD患者PCI术后MVO的效能。结果:MVO组首过灌注时间、延迟强化信号值为(4.31±1.05)s、(55.74±12.30),均高于无MVO组的(3.50±0.94)s、(38.84±9.45);而首过灌注最大上升斜率(Slopemax)为(27.25±3.20),低于无MVO组的(30.40±3.61),差异有统计学意义(P<0.05)。经多因素Logistic回归分析证实,首过灌注时间与延迟强化信号值均为CHD患者PCI术后MVO的危险因素,而Slopemax是CHD患者PCI术后MVO的保护因素(OR值=5.585、0.610、1.209;均P<0.05)。经ROC曲线分析证实,首过灌注时间、Slopemax、延迟强化信号值联合预测CHD患者PCI术后MVO的效能优于单一指标预测(曲线下面积=0.939 vs 0.744、0.796、0.846)。结论:CMR心肌灌注成像参数在CHD患者MVO预测中的价值较高。Objective:To explore the predictive value of cardiac magnetic resonance(CMR)myocardial perfusion imaging parameters in microcirculatory obstruction in patients with coronary heart disease(CHD).Methods:A retrospective analysis was conducted on the clinical data of 120 CHD patients admitted to Zhangzhou Hospital from January 2021 to December 2023.All patients were treated with percutaneous coronary intervention(PCI)under digital subtraction angiography(DSA),and were divided into MVO group(n=35)and no MVO group(n=85)according to whether coronary microcirculation obstruction(MVO)occurred.Compare baseline data and CMR myocardial perfusion imaging parameters between two groups.Using multiple logistic regression analysis to investigate the relationship between postoperative MVO and imaging factors in CHD patients undergoing PCI.Clarify the efficacy of various CMR myocardial perfusion imaging parameters in predicting MVO after PCI in CHD patients through receiver operating characteristic(ROC)curves.Results:The first pass perfusion time and delayed enhancement signal value in the MVO group were(4.31±1.05)s and(55.74±12.30),respectively,which were higher than those in the non MVO group(3.50±0.94)s and(38.84±9.45);The maximum slope of first pass perfusion was(27.25±3.20),which was lower than that of the group without MVO(30.40±3.61),and the difference was statistically significant(P<0.05).Through multiple logistic regression analysis,it was confirmed that the first pass perfusion time and delayed enhancement signal value are both risk factors for MVO in CHD patients after PCI,while Slopemax was a protective factor for MVO in CHD patients after PCI(OR values=5.585,0.610,1.209;all P<0.05).ROC curve analysis confirmed that the combined prediction of first pass perfusion time,Slopemax,and delayed enhancement signal value for postoperative MVO in CHD patients was more effective than single indicator prediction(area under the curve=0.939 vs 0.744,0.796,0.846).Conclusion:CMR myocardial perfusion imaging parameters have high

关 键 词：冠心病 微循环梗阻 心脏磁共振 心肌灌注成像 

分 类 号：R445[医药卫生—影像医学与核医学]