潘生丁负荷增强超高速MRI评价心肌灌注储备的初步研究

Myocardial perfusion reserve: assessment with gadolinium enhanced ultrafast, first pass MR imaging and dipyridamole stress

目的 评价潘生丁负荷心肌首过灌注储备磁共振成像技术对缺血性心脏病的诊断作用。方法 采用 1 5TMR成像设备对 30位健康志愿者和 2 1位经核素心肌灌注显像及冠状动脉造影检查确定有心肌缺血的患者进行潘生丁负荷心肌首过灌注储备MRI的研究 ,并对心肌灌注储备的相关参数进行定量分析以及对比研究。结果 以信号强度 时间曲线的峰时 (tp)、最大信号强度增加值(SIm)、最大上升斜率 (slope)和平均通过时间 (MTT或Tm)负荷前后的比值表示左室心肌的灌注储备值 ,则正常参考范围分别为tp - / +:1 5 5± 0 31;SIm +/ - :1 6 3± 0 77;slope +/ - :2 37± 0 6 7;(1/Tm) +/ - :2 2 6± 0 43,均高于缺血心肌 ,两组之间差异有显著性意义 (P <0 0 0 1)。在心肌灌注储备的 4个相关指标中 ,slope+/ -及 (1/Tm) +/ -两项指标能够较为全面地反映灌注储备。结论 潘生丁负荷心肌首过灌注储备MRI能够准确地发现心肌灌注储备的异常。

Objective To evaluate the clinical value of magnetic resonance first pass imaging with dipyridamole stress in the assessment of myocardial perfusion reserve Methods Gadolinium enhanced ultrafast, first pass magnetic resonance (MR) imaging with dipyridamole stress was performed on 30 healthy volunteers and 21 patients with ischemic heart disease, which had been proved by rest stress technetium 99m sestamibi myocardial perfusion imaging and coronary angiography Four parameters related to myocardial perfusion reserve including tp-/+, SIm+/-, slope+/-, (1/Tm)+/- were analyzed statistically between normal and abnormal groups Results The myocardial perfusion reserve was higher in the healthy volunteers than in the patients The normal range of the four parameters was as follows: Tp-/+:1 55±0 31;SIm+/-:1 63±0 77;Slope+/-:2 37±0 67;(1/Tm)+/-:2 26±0 43 There was significant difference between these two groups Among the 4 parameters, slope+/- and (1/Tm)+/- were proved to be more accurate Conclusion The four parameters can provide accurate information on myocardial perfusion reserve, which can be used in diagnosing ischemic heart disease Gadolinium enhanced ultrafast, first Pass MR imaging with dipyridamole stress is proved to be the most promising method to evaluate the ischemic heart disease