Gd-DTPA增强磁共振诊断心肌梗死的价值

The evaluation of Gd-DThe evaluation of Gd-DTPA-enhanced MRI in diagnosing myocardial infarction

目的 :探讨 Gd- DTPA增强磁共振成像 (MRI)诊断心肌梗死 (MI)的价值。方法 :对 2 8例确诊为首发 MI、病程在 3～ 5周的患者和 12例无心血管系统疾患的自愿受检者进行 MR平扫及Gd- DTPA动态增强扫描 ,观察、测量增强前后梗死心肌及正常心肌的强化形态和信号的动态变化。结果 :平扫 MI组 2 8例中 ,19例表现为异常的等 T1或长 T1、长 T2 改变 ,9例无明显异常 ,对照组正常心肌均呈等 T1、等 T2 表现。Gd- DTPA增强扫描 MI组 2 6例在 T1WI有异常强化 ,其形态有3种 :17例呈透壁性均匀强化 ,8例呈不均匀斑片样强化 ,1例呈环形强化 ,而对照组心肌呈均匀强化。结论 :Gd- DTPA增强 MRI能更准确显示 MI的部位和范围 ,反映梗死病灶的病理特征 。

Objective:To demonstrate the value of Gd- DTPA- enhanced magnetic resonance imaging(MRI) for diagnosing myocardial infarction(MI) in human.Method:2 8patients with AMI and 12 healthy volunteers who served as controls were undertaken plain MR and dynamic Gd- DTPA- enhanced MR scan.The appearance and dynamic variation of signal intensity(SI) in the interesting myocardium on pre- and post- contrast series imaging were analyged.Result:The images of plain scan showed that 19of infarct myocardium abnormally appeared equal- T1or long- T1、long- T2 changes.9cases with AMI appeared normal.While the plan scans of the control group all appeared equal- T1、T2 .The Gd- DTPA- enhanced MRI showed that2 6 of infarct my- ocardium had abnormaly high enhancement.Three kinds of enhanced parterns were observed. They were homogenous transmural enhancement,hetrogenous scatter enhancement and ring en- hancement.While Gd- DTPA- enhanced MRI of the control group all showed homegenous en- hancement.Conclusion:Gd- DTPA- enhanced MRI can depict the location、extent and pathologi- cal state of MI more accurately and the enhanced pattern of MI can provide more diagnostic and prognostic informations.