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心电图对于区分透壁心肌梗死和非透壁心肌梗死的可靠性:一项与磁共振成像金标准的对照试验
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作者 Sievers b. John b. +1 位作者 brandts b. 郝广华 《世界核心医学期刊文摘(心脏病学分册)》 2005年第5期41-42,共2页
Cardiovascular magnetic resonance(CMR) using contrast enhancement allows exact determination of the site and transmural extent of myocardial infarction(MI). We evaluated whether 12-lead electrocardiography can differe... Cardiovascular magnetic resonance(CMR) using contrast enhancement allows exact determination of the site and transmural extent of myocardial infarction(MI). We evaluated whether 12-lead electrocardiography can differentiate transmural from non-transmural MI or determine the site of MI by comparing the findings with those of contrast-enhanced CMR. A total of 27 patients(59.5±12.9 years) with a history of MI(6.4±2.9 months) underwent CMR(Magnetom, Siemens,Erlangen, Germany). Cine images were acquired in the horizontal and vertical long axes and short axis by TrueFISP. Contrast-enhanced CMR images were acquired in the same axes by segmented FLASH 15 min after administration of gadolinium-DTPA(0.15 mmol/kg). This showed the MI to be transmural in 11 patients and nontransmural in 16. An electrocardiogram(ECG) was recorded in all patients before CMR. T-wave alterations, descending ST depression, pathological Q-waves and absent R waves were more frequent in non-transmural MI than transmural MI, as defined by contrast-enhanced CMR (p≥0.618). However, none of the differences were statistically significant. R-wave reduction, q waves and horizontal ST-depression were more frequent in transmural than in non-transmural MI(p≥0.157). Again, the differences were not significant. The sensitivity of the ECG for MI localization was highest in inferior infarctions(85.71%), the specificity was highest in anterior infarctions (100%), the best positive predictive value(80%) was achieved for anterolateral infarctions, and the best negative predictive value for lateral infarctions(95.83%). Transmural and non-transmural MI cannot be differentiated by ECG. The ECG is most accurate in detecting anterolateral MI. 展开更多
关键词 磁共振成像 对照试验 金标准 侧壁梗死 快速梯度回波 阴性预测值 缺如 阳性预测值 差异无显著性 外侧壁
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