冠心病早期诊断中磁共振药物负荷心肌灌注成像的应用

Magnetic resonance myocardial imaging loaded with Adenosine for earlier diagnosis of coronary artery disease

目的:研究药物负荷磁共振心肌成像在冠心病早期诊断中的应用价值。方法:34例经冠状动脉造影确诊的患者,静脉注射腺苷前后进行心脏磁共振扫描,观察药物负荷对心肌灌注的影响。结果:①冠状动脉狭窄造成的心肌缺血性改变,在MRI心肌灌注中表现为灌注减低和延迟扫描无增强;②腺苷药物负荷试验可加重心肌缺血性改变,提高心肌灌注减低检测的阳性率,在<50%、50%～75%、>75%的3组冠状动脉狭窄患者中,50%～75%狭窄组增加的阳性率最为明显,与其他两组间有统计学意义(P<0.05)。结论:①腺苷药物负荷MRI心肌灌注成像和延迟扫描可用作冠心病早期诊断中的心肌缺血评估,是冠心病早期诊断的灵敏性指标。MRI心肌灌注减低和延迟增强无强化的心肌段,代表其相对应供血冠状动脉有狭窄存在;②3.0T磁共振仪可通过心肌缺血的状况评估,完善指导冠心病的临床诊断和治疗。

Objective： To evaluate the efficiency of magnetic resonance myocardial imaging loaded with Adenosine for earlier diagnosis of coronary artery disease. Methods： Thirty - four patients suffered from coronary artery disease without clinical acute coronary syndrome were received 3.0T magnetic resonance myocardial imaging. The changes of blood supply in all patients infused by Adenosine were compared, to confirm if there was myocardial ischemia. Results： ①Coronary arteriostenosis induced changes of myocardial ischemia, in MRI appeared the decrease of infusion and no strengthen of delayed scanning. ②Adenosine aggravated the changes of myocardial ischemia and increased positive rate of detecting myocardial pe＇rfusion level. Positive rate increased in 50% ～75% arteriostenosis group most significantly compared with that in lower 50% arteriostenosis group and higher 75% arteriostenosis group （P 〈 0.05）. Conclusion：①Adenosine can be used to evaluate degree of myocardial isehemia for earlier diagnosis of coronary artery disease by MRI myocardial perfusion imaging and delayed scanning. Degree of myocardial isehemia is a sensitive marker. Myocardium section with decrease of MRI myocardial perfusion and no strengthen of delayed scanning showed coronary arteriostenosis. ②3.0T magnetic resonance myocardial imaging can evaluate myocardial ischemia condition, develope clinical diagnosis and treatment of coronary artery disease.