摘要
目的采用３１Ｐ磁共振波谱（３１ＰＭＲＳ）测定国人心肌梗死（ＭＩ）病人和正常志愿者心肌细胞内的多种能量代谢化合物含量以及比值，评价３１ＰＭＲＳ在心肌缺血领域中的应用价值。方法１５例ＭＩ病人均经过临床和冠状动脉造影证实，８例健康志愿者为正常对照组。采用西门子１．５ＴＭａｇｎｅｔｏｎ６３ＳＰＭＲ扫描机，三维化学位移成像（３ＤＣＳＩ）定位技术。７例病人经皮冠状动脉腔内成形术（ＰＴＣＡ）和冠状动脉内溶栓治疗后进行３１ＰＭＲＳ复查。结果正常对照组结果显示，心肌组织磷酸肌酸／β三磷酸腺苷（ＰＣｒ／βＡＴＰ）和无机磷酸盐／磷酸肌酸（Ｐｉ／ＰＣｒ）的比值分别是１．５８±０．１９和０．３６±０．１７；ＭＩ组结果显示，心肌组织ＰＣｒ／βＡＴＰ和Ｐｉ／ＰＣｒ比值分别是０．９８±０．３１和１．２２±０．６６（Ｐ＜０．００１）。接受ＰＴＣＡ和冠状动脉内溶栓治疗后，心肌组织ＰＣｒ／βＡＴＰ和Ｐｉ／ＰＣｒ比值恢复到１．２１±０．３４和０．９６±０．２１（Ｐ＜０．０５）。结论采用３１ＰＭＲＳ首次探讨国人正常心肌和梗死心肌组织的能量代谢。在ＭＩ的病人，心肌组织细胞的高能磷酸盐并无全部耗竭。３ＤＣＳＩ技术是目前３１ＰＭＲＳ较理想的?
Objective To determine the amount of high energy phosphates and internal ratios various phosphate metabolites in myocardium of normal subjects and patients with myocardial infarction using 31 P MR spectroscopy ( 31 P MRS), and to assess the clinical value of 31 P MRS in patients with myocardial infarction (MI). Methods Fifteen patients (all men, aged 31 66 years, mean 53.8 years) of MI (acute 5, chronic 10) with ejection fraction of less than 46% and 8 healthy volunteers (normal controls) were studied using a 1.5 T Siemens Magneton 63 SP MR imager. The 10 cm diameter surface coil ( 1H and 31 P double tuned surface coil ) was employed. To minimize motion artifacts, the subjects were examined in prone position with chest wall lying just above the surface coil. 31 P MRS study was further conducted in 7 of 15 patients after PTCA and coronary thrombolytic therapy. Results In the control group, the myocardium PCr/β ATP and Pi/PCr ratio were 1.58±0.19 and 0.36±0.17, respectively, while in patients with MI, these parameters were 0.98±0.31 and 1.22±0.66 ( P <0.001). The difference between the control group and MI group was statistically significant. After therapy, these parameters turned out to be 1.21±0.34 and 0.96±0.21 ( P <0.05), respectively, which were significantly different compared with those prior to therapy. Conclusions An investigation using 31 P MRS in MI in Chinese population was first reported. The contents of high energy metabolites and their ratios in myocardium in both normal control and those with MI were studied. Myocardial high energy phosphates were not depleted in human MI. 31 P MRS possesses a great potential in evaluating myocardial viability, effects of reperfusion, and the recovery of myocardial physiologic function after reestablishment of coronary blood flow.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1999年第1期31-35,共5页
Chinese Journal of Radiology
关键词
心肌梗死
核磁共振
诊断
^31PMR波谱
Myocardial infarction Nuclear magnetic resonance Energy metabolism
