摘要
目的评价磁共振成像心肌灌注延迟显像(DE-MRI)所显示的高信号检测存活心肌的临床价值。方法 24例经彩超检查存在左室壁节段运动障碍冠心病患者,进行DE-MRI、冠状动脉造影(CAG)及介入治疗(PCI),所有狭窄病变行完全血运重建。参照美国超声心动图学会16节段划分法获得各运动异常节段心肌延迟增强,并对其进行分级,根据分级结果对心肌存活情况进行判定。术后1,3,6月时复查心脏超声,以冠脉血运重建后室壁节段收缩功能改善为判断存活心肌的金标准,根据诊断试验四格表得出DE-MRI检测存活心肌的价值。结果 24例冠心病患者共获得符合条件的室壁运动异常节段170个,根据金标准判断其中115个为存活心肌,55个为非存活心肌,DE-MRI检测存活心肌的灵敏度、特异度、准确度分别是73.3%、92.4%、86.7%。结论 DE-MRI检测冠心病患者的存活心肌有较高的临床价值。
Objective To evaluate the value of delayed-enhancement magnetic resonance imaging（DE-MRI） in the detection of viable myocardium（VM）.Methods Twenty-four hospitalized patients with regional wall motion abnormalities（RWMA） conformed by routine echocardiography underwent the DE-MRI,coronary angiography and percutaneous coronary intervention（PCI）. Every left ventricular myocardial segment image was acquired and evaluated according to 16-segment models of American Society of Echocardiography.The images of DE-MRI were ranked and differentiated VM by the rank.The motions of every segment were observed by echocardiography 1,3,6 months later.The gold standard of viable myocardium was that the motion of left ventricular segments got better after PCI.The fourfold table for diagnosis test was used to evaluate the value of DE-MRI in the detection of VM.Results In all 170 abnormal segments,there were 115 viable myocardium segments and 55 non-viable myocardium segments according to gold standard.The sensitivity,specificity and accuracy of DE-MRI in detecting viable myocardium were 73.3%,92.4% and 86.7%,respectively.Conclusion DE-MRI,as a valuable measure,can be used to detect viable myocardium in the patients with coronary artery disease.
出处
《中华全科医学》
2010年第11期1373-1373,1402,共2页
Chinese Journal of General Practice
关键词
磁共振成像
冠状动脉疾病
存活心肌
Magnetic resonance imaging
Coronary artery disease
Viable myocardium
