磁共振评估冠状动脉粥样硬化斑块的研究进展

Research progress in the evaluation of coronary atherosclerosis plaque by magnetic resonance imaging

冠状动脉粥样硬化性心脏病(coronary atherosclerosis heart disease,CHD)是人类主要死亡原因之一,其中急性冠脉综合征(acute coronary syndromes,ACS)是导致患者预后不良和发生猝死的主要原因。尸检病理结果发现,ACS发病的主要原因为动脉粥样硬化易损斑块破裂或内皮表面糜烂导致冠脉内血栓形成。磁共振成像(magnetic resonance imaging,MRI)作为一种无创、可重复性强、组织分辨率高的检查方法,多对比成像序列经过20余年的研发在颈动脉粥样硬化斑块中的应用已得到广泛证实,并在临床上及病理对照上得到进一步的验证。但冠状动脉管壁成像由于成像技术复杂,目前尚处于研究阶段。本文就磁共振成像评估冠状动脉粥样硬化斑块的研究进展进行综述。

Coronary atherosclerosis heart disease （CHD） is one of the leading causes of death, and the patients with acute coronary syndrome （ACS） is the main cause of poor prognosis and sudden death. Autopsy pathology shows that vulnerable plaque rupture or erosion of the endothelial surface with thrombus formation is recognized as the most important mechanism of acute coronary syndromes. Magnetic resonance imaging （MRI） is noninvasive, with high reproducibility and perfect soft tissue characterization. After 20 years of hard work, carotid arteries allow identification of plaque morphology using multi-contrast weighted MRI, which has got additional validation studies using histopathologic materials and clinical practice. Although, at present, coronary artery wall imaging is still in the stage of research due to the complexity of imaging technology. In this article, the research progress of magnetic resonance imaging to evaluate coronary artery atherosclerotic plaque is reviewed.