冠脉微循环检查技术的临床应用进展

Advancement with Examination Technology of Coronary Microcirculation

冠脉微循环功能障碍表现为无冠状动脉梗阻的心肌缺血,在临床中十分常见。由于冠脉微循环直径低于目前影像学检查的分辨率,所以对冠脉微循环障碍诊断主要依赖于对微循环功能的评估。常用检查方法包括冠状动脉造影血流延迟评估、冠状动脉血流储备评估(CFR)、冠脉微循环阻力指数测定、核素心肌灌注显像(MPI)、超声心肌造影、磁共振及CT心肌灌注等。每种方法各有优劣,在临床中应综合应用,取长补短,给患者带来更多的收益。

Coronary microcirculation dysfunction(CMD)is signs of myocardial ischemia without obstructive coronary disease,which is very common in clinical conditions.Since coronary microcirculation is not visible on current imaging examinations,the diagnosis of CMD is usually based on functional assessment of microcirculation.Common examination methods include assessment of delayed flow of contrast during angiography,assessment of coronary artery flow reserve(CFR)and index of microcirculation resistance,assessment myocardial perfusion by positron emission tomography,contrast echocardiography,magnetic resonance and CT.Each method has its own advantages and disadvantages.It should be comprehensively applied in clinic to bring more benefits to patients.