摘要
探讨急性心肌梗塞及再灌注的MRI征象及其病理学基础以及再灌注对心肌梗塞后左室重构的影响。材料和方法：13只小型猪开胸结扎冠状动脉左前降支制备心肌梗塞动物模型（6只）和心肌缺血再灌注动物模型（7只），于术前，术后7小时、5～7天、13～17大和1个月进行MRI检查，心脏标本进行病理检查。结果：梗塞组和再灌注组均见左心室前壁及空间隔前部T2WI上高信号，部分出现心脏内流动信号升高（其中梗塞组5例，再灌注组4例）。增强扫描两组均见心前壁明显强化，与T2WI上高信号部位、范围相同，病理检查证实其为梗塞心肌。随梗塞时间的进展，梗塞组（3只）左心室前壁变薄、膨展逐渐明显，左心室腔扩大，其中2例有室壁瘤形成；再灌注组（3只）仅1例左心室前壁变薄较明显，但无左室前壁明显膨展和左室腔扩大。结论：MRI能全面评价急性心肌梗塞的大小、范围和心脏的形态和功能等变化，对左室重构改变的评价有价值。再灌注对心肌梗塞后左室重构有限制作用。
Objective: To investigate the MRI appearances and their correlative pathologic changes of nonreperfused and reperfused acute myocardial infartion(AMI), and to evaluate the influence of reperfusion in the left ventricular remodeling after myocardial infarction.Materials and methods; Thirteen miniature pigs were given ligation of left anterior descending branch(LAD) and using'occlusive snare' method to make pathologic models of non- reperfused (6 cases) and reperfused(7 cases) AMI. All animals underwentMR imaging at pre- operation, 5~7days, 13 ~ 17days, 1 month after operation.The cardiac specimens were given pathologic examination. Results: The infracted myocardium in nonreperfused and reperfused AMI which were proved by pathology demonstrated high signal intensity of anterior myocardial wall on T2 WI and abnormal enhancemenl on enhanced T1 WI. Abnormal flowing signals in the ventricle wereseen in 5 cases of nonreperfusion AMI and 4 cases of perfusion AMI .The infrated myocardium in nonreperfused AMI became rnarked thinning and the ventricular wall became extend after operation for 1 month and 2 cases accompanied with the formaion of ventricular aneurysm. In reperfused AMI only 1 case had a thinning of anterior wall of left ventricular, but had not extending of left ventricular. Conclusion; MRI is a comprehensive noninvasive medical imaging method for evaluating myocardial infartion. MRI not only can evaluate the morphological and functional changes of heart after AMI, but also is very useful in the follow - up of the left ventricle remodling after myocardial infaretion .The reperfusion is helpful for preventing left ventricular remodeling following AMI.
出处
《中国临床医学影像杂志》
CAS
1999年第2期81-85,共5页
Journal of China Clinic Medical Imaging
关键词
磁共振成像
急性
心肌梗塞
再灌注
左室重构
Magnetic resonance imaging Acute myocardial infartion Reperfusion Left ventricular remodeling
