磁共振延迟扫描缺血性心脏病的诊断价值

The value of MRI delayed enhancement sequence in diagnosis of ischemic cardiac disease

目的 研究延迟扫描序列诊断缺血性心脏病的价值。方法 采用 1.5T磁共振扫描仪行延迟扫描序列 ,并行冠状动脉造影。结果 冠状动脉造影显示 ,2 1例患者 4 0支冠状动脉呈不同程度狭窄。延迟扫描序列显示其中 16例的 2 5支 (6 2 .5 % )心肌节段呈高信号。 16例中 11例临床诊断心绞痛患者延迟扫描阳性。 15支狭窄冠状动脉 (11支闭塞 )有侧支循环形成 ,延迟扫描显示 14支相应心肌节段阳性 ;2 5支狭窄冠状动脉 (1支闭塞 )无侧支循环 ,11支相应心肌节段呈高信号 ,两者延迟扫描阳性率差异有显著性意义 (Fisher精确检验P <0 .0 0 1)。结论 延迟扫描序列是检出心肌梗死的有效方法。冠状动脉闭塞有侧支循环形成的心肌节段较非闭塞。

Objective To investigate the diagnostic value of the delayed enhancement sequence in coronary artery disease.Method 21 patients were examined on 2D delayed enhancement sequences by using 1.5 T MR scanner and catheterized coronary angiography.Results Catheterized coronary angiography demonstrated 40 stenostic coronary arteries in 21 patients.25 subordinate myocardial regions of these arteries showed high signal intensities on the delayed enhancement sequences.11 of 16 clinically suspected angina cases were demonstrated to have high signal intensity on delayed enhancement sequences. Of 15 stenotic coronary arteries(14 occluded) with well-established collateral vessels, 14 displayed high signal intensities,while of the other 25 vessels (1 occluded) without any collateral vessels, only 11 had high signal intensities within the related segments. The difference between these two groups was statistically significant (Fisher exact P< 0.001).Conclusions Delayed enhancement sequence is effective modality for revealing infarction, especially among the patients clinically suspected to have angina and those having the stenotic coronary arteries with well-established collateral vessel.