MRI心肌灌注对存活心肌的初步研究

Study of MR myocardial perfusion imaging (MRMPI) in evaluating the viability of myocardium

目的:评价MR心肌灌注成像(magnetic resonance myocardial perfusion imaging,MRMPI)检测陈旧性心肌梗死存活心肌的作用。方法:选择陈旧性心肌梗死(急性心肌梗死发作后4周以上)患者27例。(Gd-DTPA)0.1mmol/kg、MRMPI首过期及5～30min延迟期成像。首过期行短轴面成像,延迟期行短轴面及长轴面成像。结果:27例陈旧性心肌梗死患者,17例(63％)首过期显示灌注减低;26例(96.3％)延迟增强,其中透壁型增强6例(22.2％),非透壁型增强9例(33.3％),混合型11例(40.7％);无增强1例(3.8％)。结论:MRMPI可有效地检测陈旧性心肌梗死的存活和非存活心肌,以及其程度和范围。

Objective To assess the role of MR myocardial perfusion imaging (MRMPI) in detecting the viability of myocardium for patients with old myocardium infarction (OMI). Method; MRMPI was performed on 27 patients suffering from old myocardium infarction with 1.5T MR scanner. All patients were imaged during the first-pass and delayed phase 5-30 min after injection of GD-DTPA 0.1 mmol/Kg at 5 ml/s using IR-turbo-Flash sequence. Short axis images were acquired during the first-pass, and both short axis and long axis images were taken during delayed phase. Results:In 27 patients with old myocardial infarction, 17 cases( 63%) showed hypoen-hancement during the first-pass imaging, 26 cases (96.3%) revealed delayed hyperenhancement. For delayed hyperenhancenient, 6 cases (22.2%) were transmural, 9 cases(33.3%) were nontransmural, 11cases (40.7%) the mixed, another one was normal.Conclusion: The myocardium's viability and non-viability, and their severity and extent can be effectively evaluated by MRMPI for patients with OMI.