心脏磁共振显像技术对存活心肌的评估与临床应用

Cardiac Magnetic Resonance Imaging Assessment and Clinical Use of Myocardial Viability

存活心肌的评估对冠心病的预后及治疗方案有着重要的意义,心脏磁共振成像技术对存活心肌的检出具有较强的应用价值。其检测存活心肌的手段包括:静息心脏磁共振测量室壁厚度改变,多巴酚丁胺负荷磁共振成像评估心肌收缩功能储备,对比增强心脏磁共振以及磁共振波谱来评估存活心肌,延迟增强技术对心内膜下心肌梗死及非透壁心肌梗死的诊断优势明显。3.0T心脏核磁共振的应用成倍地增加信号噪声比和对比剂噪声比,进一步提高了诊断的准确率。心肌磁共振是一项安全、无创、无放射性的检查,但其在实际应用中亦存在一些问题。

Assessment of myocardial viability is pivotal to the prognosis and treatment of coronary artery disease（CAD） .Cardiac magnetic resonance（CMR） imaging is practically valuable in detecting viable myocardial muscles with resting CMR to detect the change of ventricular thickening,with dobutamine CMR to evaluate myocardial contractile reserve,and with contrast-enhanced CMR and magnetic resonance spectroscopy to determine myocardial viability.Late gadolinium enhancement CMR imaging is obviously advantageous in the diagnosis of subendocardial and nontransmural infarction.Application of 3.0T CMR multiplies the signal-to-noise ratio（ SNR） and contrast-to-noise ratio（ CNR） ,further improving the accuracy of diagnosis.It is a safe,noninvasive and nonradioactive examination.Whereas there are some problems in practical application.