心肌梗死心脏MRI相关参数分析

Analysis of MRI Parameters in Myocardial Infarction

目的:探讨心肌梗死患者心脏MRI确定的梗死质量、梗死百分比、透壁程度、左室功能的差异。方法:对42例发病在1个月以上的心肌梗死患者行1.5T电影MRI检查后,以4ml/s的速率静脉注射Gd-DTPA 0.1mmol/kg行首过灌注成像,随后以2.5ml/s的速率静脉注射Gd-DTPA 0.1mmol/kg,5～10分钟后行延迟强化成像。评价其梗死质量、梗死百分比、透壁程度、左室功能并进行对比分析。结果:与非ST段抬高心肌梗死(NSTEMI)患者相比,ST段抬高心肌梗死(STEMI)患者梗死质量、梗死百分比、受累段数、透壁段数均有增加趋势,但未达到统计学差异。与非透壁心肌梗死相比,透壁心肌梗死患者梗死质量、梗死百分比更大,左心室功能无显著性差异。ST/非ST段抬高心肌梗死与透壁/非透壁心肌梗死相关。结论:STEMI较NSTEMI患者心肌受损更为严重,STEMI通常为透壁心肌梗死。

Objective： The aim of the current study was to analysis of cardiovascular magnetic resonance imaging（CMRl）parameters in ST- segment elevation myocardial infarction（STEMl） or none-ST- segment elevation myocardial infarction（NSTEM1）.Methods：Patients with first MI （n=42） were selected to undergo CMR1 on a 1.5 Tesla system.The global LV functions were calculated with a standard cine MRI and a stack of short axis slices encompassing the entire ventricles. A first-pass perfusion scan was acquired simultaneously with the administration of Gd-DTPA at a dose of 0.1mmol/kg body weight. Following with a second bolus of 0.1 mmol/kg body weight,myocardial delayed enhancement （MDE） was performed 5 to 10 minutes later by using an ECG-gated inversion-recovery fast-gradient echo-pulse sequence. Infarction mass （IM）, percentage size of infarction（PSl）, transmural extent and left ventricle functions（LVF） were determined for each patient. The 12-lead ECG in acute phase was analysed for ST-elevation. Results：Compared with NSTEMI, there was a increasing trend in IM, PSI,involved segment and transmural extent in STEMI, yet did not marked divergence in the statistics. Compared with non transmural MI（NTMI）, there were more IM（P=-0.002） and PSI（P=0.000） in transmural.Ml （TMI）. LVF was no difference between NTMI and TMI. There was a statistically correlation between STEMI and TMI（P=0.032）. Conclusions：Compared with NSTEMI, myocardial injury was more serious in STEMI. It was more frequently for STEMI to be TMI.